What is rheumatism of the joints?Acute rheumatic fever( rheumatic fever) is a pathology of the connective tissue of infectious etiology, which is characterized by systemic autoimmune manifestations. Another name for this disease - Sokolsky-Buyo's disease - is given in honor of two scientists who discovered the essence of pathology.
Etiology of the disease
The main etiological factor leading to the development of the disease is Streptococcus pyogenes( beta-hemolytic streptococcus serogroup A), provided that there is a predisposition to the disease. Not all people who have suffered an acute streptococcal infection develop rheumatism.
Rheumatism is more common in children and adolescents after having had angina or scarlet fever.
The Russian Association of Rheumatologists in 2003 proposed a new working classification of rheumatism.
The following forms of rheumatic fever are distinguished:
- acute - primary episode of the disease;
- repeated - is a repeated episode of acute.
Depending on the clinical picture, the main manifestations are:
- carditis - defeat of the heart valves( mitral, less often aortic);
- anuricular erythema;
- subcutaneous rheumatic nodules.
- fever, usually febrile;
- arthralgia - volatile pain in the joints without manifestations of inflammatory reactions;
- abdominal syndrome;
- serosites - an inflammation of serous membranes.
As options for the outcome of the disease are possible:
- formation of chronic rheumatic heart disease without the formation of a defect or with a blemish.
Classification also implies the determination of the stage and functional class of circulatory insufficiency that occurs when the heart tissue is damaged.
Symptoms of rheumatism
The first signs of the disease appear, usually two weeks after the transferred infectious disease. Clinical forms of the manifestation of the disease include:
- rheumatic carditis - a heart lesion that determines the severity of the course, the prognosis and outcome of the disease;
- rheumatic polyarthritis - symmetrical lesion of large and medium joints;
- small chorea( Sydenham's chorea) - manifested by multiple violent movements of the muscles of the trunk, limbs, face. Often occurs in girls;
- annular erythema - the appearance on the body of ring-shaped rashes of pale pink color. It is rare.
What is rheumatism of the joints?
Joint damage in rheumatism has certain peculiarities:
- is characterized by involvement of the elbow, ankle, knee joint, less frequently wrist, in the inflammatory process;
- has a so-called volatile( migratory) character, which is manifested by alternating swelling, redness and soreness of each affected joint. There may be simultaneous inflammation of several joints;
- shows a significant positive dynamics with non-steroidal anti-inflammatory drugs;
- rheumatism of the joints has a benign course( without persistent disruption of joint function), characterized by a reversible development of symptoms in the vast majority of patients.
Duration of joint manifestations in the absence of adequate therapy can be up to three weeks. Clinical manifestations of rheumatic polyarthritis include the following symptoms:
- uniform edema in the region of affected joints;
- redness of the skin over the joints, increase in its temperature;
- marked, sometimes unbearable soreness in palpation and movements;
- the affected joints are in a semi-bent state;
- there is febrile fever and profuse sweating.
As a rule, the rheumatic attack is rarely manifested by isolated arthritis without signs of heart damage. In the same few cases, when this occurs, there are characteristic features of this manifestation of the disease:
- is more common in adults;
- the period between the transferred streptococcal infection and the debut of arthritis is reduced to 1-2 weeks;
- no effect of NSAID therapy;
- longer duration( up to 2 months).
In clinical practice, mainly children's rheumatism occurs. The appearance of symptoms in an adult, as a rule, is a relapse of a previous illness.
Rheumatism does not have any diagnostic test that allows you to fully verify the disease. To establish the diagnosis, it is customary to identify certain diagnostic criteria.
To major criteria include the main clinical manifestations of the disease:
- heart tissue damage;
- choreic hyperkinesis;
- ring-shaped rashes;
- rheumatic subcutaneous nodules.
Small criteria include the following manifestations:
- rheumatism in an anamnesis;
- joint pain;
- presence of fever;
- changes in blood tests( leukocytosis, detection of CRP, increased ESR);
- increase in the titer of streptococcal antibodies: ASL-O, ADRN-B, ASA, in most patients an increased titer of at least one of the indicators is determined;
- recently transferred streptococcal infection.
For diagnosis, two large or one large and two small criteria should be present, combined with an indication of a streptococcal infection.
Treatment of rheumatism
Patients are treated in a hospital where complex therapy is provided, including:
- bed rest for the first few weeks;
- etiotropic therapy - appointment of penicillin group drugs intramuscularly for 2 weeks;
- anti-inflammatory treatment - use prednisolone, non-steroidal anti-inflammatory drugs.
Self-treatment of this disease in the home is fraught with serious consequences.
Prevention of rheumatism
The following measures can be applied to methods of primary prevention:
- hardening of the body;
- timely antimicrobial therapy of angina.
Secondary prophylaxis is a further follow-up of people who have transferred the disease, aims to achieve the following goals:
- prevention of disease progression,
- prevention of the development of repeated attacks.
Secondary prophylaxis means the regular administration of a prolonged form of penicillin. Duration for rheumatism without carditis is at least five years and longer or even life-long in the presence of heart damage.
Thus, rheumatism of the legs and hands is a serious disease, which is often accompanied by a defeat of the heart with the formation of a blemish and requires timely diagnosis and adequate treatment in a rheumatological department.
Rheumatism: Symptoms and Treatment
Rheumatism( acute rheumatic fever) is an immunological systemic inflammatory disease of connective tissue caused by group A B-hemolytic streptococcus, with a predominant lesion of the heart, vessels of small caliber and joints.
Most often rheumatism develops in children, 7-15 years old, who have had an infection of the upper respiratory tract( sore throat, etc.) without timely treatment.
Reasons and mechanism of rheumatism development
Symptoms and signs of rheumatism
Treatment of illness + interesting video!
Prevention of rheumatism
The causes and mechanism of the development of rheumatism
for rheumatism is primarily affected by the heart
The genetic predisposition is of great importance in the occurrence of rheumatism, which proves a high incidence rate within the same family, as well as the presence of special genetic markers.
There are two main points in the development of rheumatism:
1. Direct exposure to toxins that secrete hemolytic streptococcus: hemolysins, hyaluronidase, proteinase, etc.;
2. The immune response of the body to streptococcal antigens, resulting in the synthesis of special antibodies that have a damaging effect on the heart cells, small vessels, skin, synovial membrane of the joints.
Main symptoms and signs of current rheumatism
The disease usually starts with tonsillitis
As a rule, rheumatic fever in children or adults develops acutely, a few weeks after the tonsillitis or strepitis of streptococcal etiology. When the child, it would seem, has already almost recovered and is ready to return to the educational process, his temperature rises sharply to 38-39 degrees.
There are complaints of symmetrical pain in the large joints( most often the knee), which have a distinctly migratory nature( today knees hurt, tomorrow elbows, then shoulders, etc.).Soon pains in the heart, shortness of breath, palpitations join.
Heart attack in the first rheumatic attack is observed in 90-95% of all cases. This can affect all three walls of the heart - endocardium, myocardium and pericardium. In 20-25% of cases, rheumatic carditis results in a formed heart disease.
The main feature of heart damage in rheumatism in children and adults is the extreme scarcity of manifestations. Patients complain of unpleasant sensations in the heart, dyspnoea and cough after physical exertion, pain and irregularities in the heart. As a rule, children are silent about these complaints, without giving them serious significance. Therefore, the defeat of the heart most often can be identified even with a physical and instrumental examination.
Joint rheumatism begins acutely
Very often joint damage with rheumatism comes to the fore. As a rule, the inflammatory process in the joints begins acutely, with severe pain, swelling and redness of the joints, an increase in temperature above them, and restriction of movements.
Joint rheumatism is characterized by damage to the joints of large and medium caliber: elbow, shoulder, knee, ray, etc. Under the influence of treatment, all symptoms are quickly leveled without consequences.
Lesion of small joints of hands or feet is usually observed with repeated rheumatic attacks. More often, such lesions with rheumatism of joints do not pass without leaving a trace, leading to fibrotic changes in capsules of the joints, with the development of deformity of the fingers and arthritis Jacques.
Rheumatoid arthritis or joint rheumatism in most cases develops with carditis and chorea, but can proceed in isolation. This suggests a more severe course of arthritis, resistance to therapy and pronounced joint damage.
Characteristic features of rheumatoid arthritis:
- acute onset;
- symmetrical lesion of large joints;
- volatility of pain: the localization of pain is constantly changing;
- rapid regression of the symptoms of rheumatism under the influence of treatment and the absence of irreversible changes in the joints.
Rheumatic chorea( small chorea)
chorea( dance of St. Witt)
This complication of the disease rheumatism develops mainly in girls 10-12 years old.
This is a rheumatic affection of the nervous system, which is manifested by characteristic symptoms:
- hyperkinesis - the appearance of involuntary motor activity of the limbs;
- muscular dystonia - sharp muscle spasms, accompanied by painful sensations;
- coordination disorder;
- speech impairment.
Rheumatic skin lesions
Most often manifested in the form of ring-shaped erythema and subcutaneous rheumatic nodules.
Ring-shaped erythema - a dull pink spot that tends to increase in size, gradually fading in the center, acquiring the appearance of a ring. The appearance of spots is not accompanied by painful sensations, they do not protrude above the surface of the skin and disappear completely when pressed. Ring-shaped erythema is always located on the body and never on the scalp.
Subcutaneous nodules are a fairly rare specific symptom that occurs in children with recurrent rheumatism. Most often nodules are accompanied by the phenomenon of arthritis and carditis, located on the surface of large joints. These are small( 1-2 mm to 1-2 cm) subcutaneous nodules, dense, slow-moving and painless to the touch. After the main symptoms subsided, the nodules also undergo a reverse development in 1-2 months, leaving no traces behind them.
Lesions of other organs and systems
Occur very rare and occurs without any specificity, being a manifestation of rheumatic vasculitis - a lesion of small vessels. Most often affected lungs, liver, kidneys, endocrine organs, eyes, abdominal cavity.
Treatment of rheumatism
In the treatment of this complex disease with the name rheumatism, the following groups of drugs are used:
- Antibiotics. Used to eliminate the focus of infection in the nasopharynx.
treatment of the disease begins with antibiotics
The most active in this regard remain antibiotics penicillin series. Begin treatment with benzylpenicillin intramuscularly, or amoxicillin. If penicillins are intolerant, it is possible to prescribe antibiotics from the macrolide group( azithromycin, roxithromycin, clarithromycin).
- Non-steroidal anti-inflammatory drugs( more about them - here).Are shown at development of a rheumatic arthritis, more often, a carditis of easy and average degree. The drug of choice is diclofenac or acetylsalicylic acid. Ibuprofen is also possible.
The intake of NSAIDs should be at least one month, with a gradual decrease in dose. Under their influence, there is a rapid disappearance of pain in the joints, chorea, dyspnea, positive dynamics in the ECG picture. However, in the treatment of NSAIDs, one must always remember about their negative effects on the gastrointestinal tract.
- Glucocorticoids. Applied with severe carditis, a significant accumulation of fluid in the cavity of the heart bag, severe joint pain.
- Metabolic therapy and vitamins. Assign a large dose of ascorbic acid, with the development of chorea - vitamins B1 and B6.To repair damaged cells of the cardiac muscle, apply riboxin, mildronate, neoton, etc.
Important: Treatment of such a complex disease as rheumatism in children or adults should only be done by a doctor. Do not self-medicate, this can lead to serious complications! If the first symptoms described in the article occur, be sure to consult a doctor internally!
Prevention of rheumatism
exercise - good disease prevention
Primary( nonspecific) disease prevention rheumatism is aimed at preventing the development of rheumatic process in the body and includes a set of fortifying measures: hardening, exercise, balanced nutrition, etc.
Secondary( specific) - prevention of repeated relapses of rheumatism. This is achieved by the introduction of prolonged penicillin preparations. It is possible to introduce and import analogues - retarpen, pendepon, etc.
According to WHO recommendations, prevention of rheumatism with bicillin should be carried out at least 3 years after the last attack, but not before reaching the age of 18.With the transfer of carditis - 25 years. Persons with developed heart failure should take preventive measures throughout their life.
Possible complications ↑
In the absence of treatment, rheumatic heart disease occurs.
Heart palpitations and heart rate, heart pain and heart rate irregularities suggest that inflammation of the heart tissue develops, accompanied by shortness of breath, sweating and weakness.
Other effects of untreated chronic joint rheumatism include:
- rheumatoid arthritis( characterized by chest pain, cough, shortness of breath and fever)
- rheumatic skin lesions( subcutaneous rheumatic nodules or annular erythema);
- if nervous tissue is involved in the inflammatory process, the patient has uncontrolled muscle contractions( grimaces, sharp movements, speech becomes indistinct, handwriting is broken).
The diagnosis can only be made by a rheumatologist.
For this purpose a complex examination of the body is appointed:
- a general clinical blood test is necessary to detect signs of inflammation in the body;
- immunological analysis of blood is done in order to find in it characteristic for rheumatism substances( they appear in the blood a week after the onset of the disease and concentrate as much as possible on 3-6 weeks);
- heart echocardiography and electrocardiography is used to assess the condition of the heart, determine or exclude its lesions;
- for the evaluation of the joint condition, X-ray of the joints, biopsy, arthroscopy and puncture for the examination of the joint fluid.
If there are lesions of other organs, you may need to consult other specialists.It hurts to move your fingers in the morning? Find out why the joints of the fingers are aching, from our article.
What causes pain in the elbow? Read here.
Than to treat an arthrosis of a humeral joint? All the necessary information in this material.
How to treat?↑
Rheumatism occurs as a chronic disease with periodic remissions and exacerbations.
During periods of exacerbation, patients are advised to limit the number of movements to reduce the burden on the joints. To do this, they are shown bed rest.
In case of mild illness it is sufficient to observe a semi-fast mode for 10 days.
An easy form of the disease can be treated at home.
In severe, or rheumatism of moderate severity, strict bed rest is required from 2 weeks to 1 month.
According to indications in the dynamics, with the normalization of the general condition and the indicators of laboratory studies, you can gradually increase the activity of movements.
Completely cure rheumatism is impossible, but can not be treated at all.
Ideally, if the complex applies all possible measures to combat this disease: medicamentous, physiotherapy treatment, diet, etc.
The success of treatment will largely depend on the correct choice of medication.
For the treatment of joint rheumatism, several types of drugs with different effects are used:
- Non-steroidal anti-inflammatory drugs. Necessary to eliminate pain symptoms and suppress the inflammatory process in connective tissue.
- Antibiotics. The main task in the treatment of rheumatism is the suppression of streptococcal infection, which is a provoker of the disease and subsequent complications. To do this, antibacterial agents of the penicillin group and their analogs or broad-spectrum antibiotics( erythromycin, ampicillin, etc.) are used. Such therapy lasts up to 15 days. In the future, for the prevention of recurrence and complications on the heart for 5 years 1 time in 20 days, the patient is injected with this drug.
- Immunosuppressants. Immunosuppressants weaken the body's response to infection, slightly suppress the immune response.
- Corticosteroid hormones. Assigned if antibiotics and NSAIDs are ineffective in controlling rheumatism. They combine with other drugs to eliminate all unpleasant symptoms for several days.
All agents used for treatment are effective, but have certain contraindications.
Therefore, to minimize their harmful effects from prolonged use and increase the effectiveness of therapy, a complex treatment is prescribed. It is carried out under the strict supervision of a doctor.
Treatment of joint rheumatism with folk remedies is possible.
And for many years, traditional medicine has accumulated many recipes to combat this disease. But it is better to carry out treatment in combination with medication.
It is advisable to consult with your doctor about the appropriateness and correctness of this treatment.
- Two tablespoons of fresh dandelion flower flowers are crushed and add 2 tablespoons of sugar. Leave in a cool place for 7-10 days, then squeeze the juice and take it 3 times a day for 20 drops.
- In 200 ml of vodka, insist for 1 week 30 grams of leaves of the yellow acacia. Take 20 drops of tincture in the morning, lunch and evening.
- Elm bark( 20 grams) pour a glass of boiling water and do not remove from the fire for 10 minutes. Then leave for 3 hours. Prepared tincture can be taken on 1 spoon 4 times a day.
- Roots of wild rose and chopped vodka. Within 2 weeks, insist in a dark place. Take 1 spoonful three times a day.
- The fruits of sea buckthorn, red mountain ash or physalis also have an anti-rheumatic effect. From them prepare broths and tinctures.
- Pharmacy tincture of barberry is taken 30 drops 3 times a day.
- Squeeze the juice of nettle, take the same amount of honey and concentrated alcohol. All this is mixed and left in the refrigerator for 15 days. Take 1 spoonful 3 times a day shortly before meals. The course of admission is six months.when developing arthritis is recommended to use until the movements in the joints are not easy and free.
- Take 40 grams of chopped garlic, pour 100 ml of vodka, and insist in a dark place for 10 days, periodically shaking. Take 10-15 drops 3 times a day.
Teas and decoctions:
- Green tea is very useful for rheumatism. It should be drunk at least 3 times a day.
- Black tea with raspberry berries( 30 grams of berries per glass of tea) also helps fight the symptoms of inflammation.
- Herbal teas made of fattened thick bean, bearberry, cocklebur, shepherd's bag, yarrow, tartar, violets, daisies or alfalfa are useful.
- A mixture of carrot and celery juice in a ratio of 7: 3 to drink every day.
- Broth from the roots of burdock and elecampane should be taken within 2 months 2 spoons 3 times a day.
Even popular medicine recommends patients with rheumatism joints to take a bath with a decoction of flowers of chamomile, clover, thyme, roots of wild rose or ayr.
In the treatment of rheumatism, nutrition should also be given attention: the main thing is that the body receives all the necessary substances.
Doctors recommend adhering to diet No. 15, increasing the protein component of the diet and reducing the intake of carbohydrates and salt. Do not forget about fruits and vegetables, drink warm drinks: tea with raspberries, decoction of linden.
It is recommended to exclude from food:
Rheumatism: symptoms, diagnostics, treatment
Rheumatism is an inflammation of the connective tissue with the primary localization of the process in the cardiovascular system.
The development of rheumatism is closely related to a previous acute or chronic nasopharyngeal infection caused by streptococcus, directly or indirectly, by the damaging effect of its components and toxins on the body with the development of immune inflammation.
For selective damage to the valves of the heart and myocardium with the development of immune aseptic inflammation, anti-streptococcal antibodies that cross-react with the tissues of the heart( molecular disguise) are responsible.
An important role is assigned to genetic factors, which is confirmed by the more frequent incidence of children from families in which one of the parents suffers from rheumatism.
Symptoms of rheumatismDo you suspect this disease in yourself or someone? Or was it diagnosed in you? Check using the new online guide with over 3000 symptoms and 90% confidence in the tests. There is a free option. Pass diagnostic
Rheumatism is characterized by a variety of manifestations and variability of the flow. As a rule, it occurs at school age, less often in preschool children and practically does not occur in children under 3 years old.
- In typical cases, the first signs of rheumatism in the form of fever, signs of intoxication( fatigue, weakness, headache), joint pain and other manifestations of the disease are detected 2-3 weeks after sore throat or pharyngitis.
- One of the earliest signs of rheumatism is joint pain, detected in 60-100% of cases( rheumatoid arthritis).
- Rheumatoid arthritis is characterized by acute onset, involvement of large or medium joints( often knee, ankle, elbow), rapid reverse development of the process.
- Symptoms of heart disease are defined in 70-85% of cases. Complaints of a cardiac nature( pain in the heart, palpitation, dyspnea) are noted with severe cardiac disorders.
- More often, especially at the onset of the disease, there are a variety of asthenic manifestations( lethargy, malaise, fatigue).
The rarer symptoms of rheumatism include annular rash and rheumatic nodules.
Annular rash( annular erythema) - pale pink soft rashes in the form of a thin annular rim that does not rise above the surface of the skin and disappear when pressed. The rash is found in 7-10% of patients with rheumatism, mainly at the peak of the disease and is usually unstable.
Subcutaneous rheumatoid nodules are round, dense, inactive, painless, single or multiple formations with localization in the area of large and middle joints, spinous processes of the vertebrae, in the tendons. Currently, there are rare, mainly with severe rheumatism, remaining from a few days to 1-2 months.
Abdominal pain, damage to the lungs, kidneys, liver and other organs with rheumatism is currently extremely rare, mainly in severe its course.
Photo: ring-shaped eczema as a sign of rheumatism
ECG often shows irregularities in the rhythm.
Radiographically( in addition to not always expressed increase in the heart), signs of a decrease in the contractile function of the myocardium, a change in the configuration of the heart are determined.
Laboratory indicators in patients with rheumatism reflect the signs of streptococcal infection, the presence of inflammatory reactions and the immunopathological process.
The active phase is determined: leukocytosis with a shift to the left, an increase in ESR, often anemia;increased serumucoid, diphenylamine reaction;disproteinemia with hypergammaglobulinemia;increase of titers of ASG, ASLO, increase in immunoglobulins( Ig) of class A, M and G;C-reactive protein( CRP), circulating immune complexes, anticardial antibodies.
Treatment of rheumatism
Treatment of rheumatism is based on the early appointment of complex therapy aimed at suppressing streptococcal infection and the activity of the inflammatory process, as well as preventing the development or progression of heart disease.
The implementation of these programs is carried out on the principle of phasing:
- Stage I - inpatient treatment,
- II stage - aftercare at a local cardio-rheumatological sanatorium,
- Stage III - dispensary observation in a polyclinic.
1. At the first stage in the hospital, the patient is prescribed drug treatment, nutrition correction and therapeutic exercise, which are determined individually, taking into account the characteristics of the disease and, above all, the severity of the heart.
In connection with the streptococcal nature of rheumatism, treatment is carried out with penicillin.
- Antirheumatic therapy involves one of the non-steroidal anti-inflammatory drugs( NSAIDs), which is administered alone or in combination with hormones, depending on the indications.
- Antimicrobial therapy with penicillin is carried out for 10-14 days.
- In the presence of chronic tonsillitis, with frequent exacerbations of focal infection, the duration of treatment with penicillin is increased or additionally used by another antibiotic - amoxicillin, macrolides( azithromycin, roxithromycin, clarithromycin), cefuroxime axetil, other cephalosporins in the age-related dosage.
- NSAIDs are used for at least 1-1,5 months before the signs of activity are eliminated.
- Prednisolone in the initial dose is prescribed for 10-14 days before the effect is obtained, then the daily dose is reduced by 2.5 mg every 5-7 days under the control of clinico-laboratory indicators, in the following the drug is canceled.
- The duration of treatment with quinoline preparations for rheumatism is from several months to 1-2 years and more, depending on the course of the disease.
In hospital conditions, the elimination of chronic foci of infection, in particular, the tonsillitis surgery, carried out 2-2.5 months after the onset of the disease, in the absence of signs of activity of the process, is also carried out.
2. The main task at the second stage is to achieve complete remission and restore the functional capacity of the cardiovascular system.
The sanatorium continues the therapy begun in the hospital, treats the foci of chronic infection, implements the appropriate treatment and health regime with differentiated motor activity, exercise therapy, and hardening procedures.
3. The III stage of complex therapy of rheumatism provides for the prevention of relapse and progression of the disease.
To this end, penicillin preparations of prolonged action, mainly bicillin-5, are used, the first administration of which is carried out even during inpatient treatment, and then - once every 2-4 weeks all the year round.
Regularly, 2 times a year, an outpatient examination is carried out, including laboratory and instrumental methods;appoint the necessary recreational activities, therapeutic exercise.
For rheumatism without cardiac involvement, bicillin prophylaxis is carried out for 5 years after the last attack.
In the spring-autumn period, along with the introduction of bicillin, a monthly course of NSAIDs is shown.
Prevention of rheumatism is divided into primary and secondary.
Primary prevention is aimed at preventing rheumatism and includes:
1. Enhance immunity( hardening, alternating load and rest, nutrition, etc.).2. Detection and treatment of acute and chronic streptococcal infection.3. Preventive measures in children predisposed to the development of rheumatism: from families in which there are cases of rheumatism or other rheumatic diseases;often with nasopharyngeal infection;having chronic tonsillitis or who underwent an acute streptococcal infection.
Secondary prophylaxis is aimed at preventing recurrences and progression of the disease in patients with rheumatism in conditions of dispensary observation.
Forecast for rheumatism
Currently, with timely treatment, the primary heart disease ends in recovery.
The formation of valvular heart disease, more often with the development of mitral insufficiency, is defined in 15-18% of cases in the first attack, mainly in severe, prolonged or latent course of the disease.
Find out your probable disease and to which doctor should go.
8-15 minutes, there is a free option.
Knee joint rheumatism: symptoms and treatment with folk remedies
Age features of
Many people mistakenly believe that rheumatic polyarthritis is a "senile" disease. In fact, elderly people suffer from rheumatism extremely rarely. The peak of activity of this ailment falls on a completely harmless age - from 7 to 15 years. There are cases of infant and child rheumatism, when the child suffers this disease, not being able to walk.
In general, statistics say that 80% of people with rheumatism meet before the age of 40, and only the remaining 20% are elderly and retirees. Thus, the risk group is quite young, active people who should listen carefully to their body, and also clearly know the reasons that contribute to the development of the disease and the symptoms pointing to it.
With regard to gender, most of those who suffer from rheumatism of the knee are women. To connect this with the wearing of uncomfortable shoes, doctors are not taken, but statistics distinguish this category as the main one.to the table of contents ↑
Causes of the disease
Quite often the disease occurs in people with a hereditary predisposition to rheumatism. In addition, carriers of rheumatism are people with weak immunity and an equally weak physical form. The reasons for the development of rheumatism are multifaceted:
- Infectious diseases( most common are tonsillitis, tonsillitis, otitis, chronic pharyngitis)
- The presence of protein in the body of the group B
- Streptococcal infection is one of the main causative agents of rheumatism
- Allergic reactions, on the beta-hemolytic streptococcal viruses of group A)
With regard to the specific nature of the spread of rheumatism to certain joints, according to medical research, usually a joint is affected, which is subject to daily stresses due to professional, social activities or sports training. In addition, the cause of joint damage may be earlier injuries, bruises, compression of the joint and the above-named hypothermia. Therefore, children who often like to run barefoot in puddles or cold ground, are most prone to rheumatism due to hypothermia of the feet.to the table of contents ↑
Symptoms of joint rheumatism
Rheumatism developing in the human body may not always be manifested by any signs. The first symptoms that should push a person to meditate and visit a doctor are soreness of the knee joint. A little later, a local increase in temperature is added to the painful sensations. Progression of the disease will manifest new symptoms:
- Intensive pain
- Increase of body temperature as the presence of inflammatory process( sometimes up to 40 degrees)
- Restriction of movements
Rarely rarely rheumatism affects only one joint, the most frequent cases are the development of rheumatic polyarthritis in several joints. Pain pattern is as follows:
- Development of pain in one joint
- Decrease after several hours of pain
- Disappearance of puffiness and redness
- Appearance of soreness in the other joint
- Attachment to pain of temperature, swelling, hyperemia;
- Symptoms in different joints are similar in nature.
All this indicates a kind of rolling character of rheumatism, but at the same time systematic and not disappearing. Treatment, started in a timely manner, is able to suspend this "volatility".In the absence of the same prompt and effective therapy, the symptoms will be permanent, and during the following time, new joints will be affected.
The danger of such a reaction is that rheumatism can begin to spread not only to the knee joint, but also to other joints of the lower limbs, which will lead to the isolation of movements and strong painful sensations.
The nature of pain in rheumatism can be either systematic or not permanent. In addition, the pain can occur quite unexpectedly, abruptly and just as suddenly go through. It is worth remembering that rheumatism is not a disease that destroys the joint or bone. This is an inflammatory process that can be completely "wiped out" if appropriate treatment is prescribed. But while the disease is present, pain can be of a migratory nature, be sharp and long.
It is much easier to determine that something is wrong with the body when symptoms are present. Rheumatism can perfectly shade its signs. First of all, a person should be called into question the systematic nature of the pain inherent in rheumatic polyarthritis. Despite their age, young people are more likely to notice the disease. In the elderly, the degree of pain is blunted. In addition, the already passive motor activity and joined rheumatism may not always arouse suspicion on the part of the elderly, that there is a problem with the legs.
Rheumatism as an inflammatory disease can last from a week to 3-5 months. Undoubtedly, its duration directly depends on diagnosis and therapy. Timely treatment can save a person from pain once or for all or at least guarantee for the future full awareness of the approaching relapse.to the table of contents ↑
Treatment of the disease
In order for the treatment to have a positive result, it is very important to consult a doctor at the first symptoms and suspicions of rheumatism. Therapeutic efficacy depends on factors such as:
Joint rheumatism: symptoms and causes
Rheumatism - the causes of
At present, a large number of pathologies that fall under the definition of "rheumatic diseases" are known - rheumatism is the only disease in this clinical group, having a known cause and mechanism of development. That is why in those cases when the disease of rheumatic fever is revealed, the treatment started with the appearance of the first symptoms allows to completely stop all manifestations of the pathological process and restore the patient's health in full.
The reason for the development of rheumatism is beta-hemolytic streptococcus of group A, which in latent form can live for a long time on the mucous membrane of the oral cavity, in the lacunae of the tonsils. With the weakening of local immunity, the microorganism becomes the cause of the development of acute tonsillitis( tonsillitis) or chronic inflammation of the palatine tonsils - and in both cases, acute articular rheumatism occurs 10-14 days after this.
It is during this time in the body, sensitive to toxins released by streptococcus, have time to form specific antibodies, fixation of which on the membranes of the cells of the synovial membrane of the joints, endocardium of the heart, neurons of nervous tissue becomes the cause of the development of aseptic inflammation. In this case, the microorganism does not penetrate into the blood - inflammations are the result of the perverted immunological reactions of the organism.
It should be noted that the condition that older patients call rheumatism of the back is actually a manifestation of non-inflammatory, and metabolic-degenerative degenerative joint disease - osteochondrosis.
Joint rheumatism: symptoms
It is proved that rheumatism remains the primary localization of the lesion in this disease - the symptoms of arthritis are so characteristic that the doctor can correctly diagnose the result of the examination of the patient. The classical definition of rheumatism as a disease includes the presence of the patient:
- of volatile polyarthritis, which is characterized by the rapid occurrence and reverse development of symptoms of joint inflammation, while rheumatism of the legs( large joints of the lower extremities) occurs most often;
- in that case, when rheumatism develops - body temperature rises suddenly , simultaneously with the appearance of signs of joint damage;
- expressed general weakness, malaise, sweating;
- a clear association of symptoms of the disease and streptococcal infection;
- evidence of treatment is the rapid disappearance of all complaints after administration of antibiotics and non-steroidal anti-inflammatory drugs.
Even if treatment for one reason or another is not prescribed and will not be performed, chronic rheumatism of the joints will occur. And the symptoms of arthritis will be repeated cyclically, but deformations of articulations do not develop. The development of acute rheumatic endocarditis is a great danger for the life and health of the patient. This process proceeds practically without characteristic symptoms, but it causes the formation of various acquired heart defects, the severity of which largely predetermines the prognosis and tactics of treating rheumatism.
Rheumatism - Symptoms and Treatment
Rheumatism is a disease that is completely inadmissible self-medication - in the absence of drugs that can kill streptococcus in the body( broad-spectrum antibiotics) and eliminate the inflammation that has arisen in the connective tissue( non-steroidal anti-inflammatory drugs), it will not be possible to avoid the development of acquired heart disease and progressive insufficiencyblood circulation.
The treatment program and specific drugs should be prescribed by a qualified rheumatologist. At the same time, the patient's condition, tolerability of the recommended therapy and its effectiveness are necessarily taken into account. If the patient does not improve in 4-5 days after complex treatment, other causes of inflammation of the joints and heart damage must be excluded.
- About the author
- The last articles
Rheumatism of joints - symptoms and treatment
In this article I will tell you about rheumatism of joints: we will talk about its symptoms of and treatment of , and discuss some of the related misconceptions.
Very often, when I enter my office, a middle-aged man or woman from the doorway says: "Doctor, my joints hurt. It's probably rheumatism."As a specialist, I always get a smile from such statements, because in fact rheumatism of is much less common than people imagine.
In addition, rheumatism is a disease of children and adolescents aged 6 to 15 years. The chance of getting this disease in those who are more than 30 years old, is almost zero. And even in the classical age group of children 6-15 years old, rheumatism suffers from only one child in a thousand.
The question arises: if rheumatism is so rare, why do we often hear this term? Most likely, the "memory of ancestors" is affected. In former times rheumatic arthritis was more common. But over the past 50 years, due to the appearance of antibiotics and the efforts of medicine, the incidence of rheumatism in our country has decreased several times.
The second reason why rheumatism in earlier times was mentioned much more often refers to the category of literature. Earlier, the word "rheumatism" was used to designate any joint diseases - arthrosis and arthritis.
Doctors simply did not need to differentiate various joint diseases - in fact, in most cases, all of them were treated by the same methods, because the choice of healing procedures was small. Fortunately, now the possibilities of medicine have significantly increased. And in our time, no competent rheumatologist or arthrologist will not confuse the manifestations of true rheumatism with the symptoms of some other disease.
Symptoms of rheumatism
Manifestations of rheumatism are very characteristic. As already mentioned, mostly children and adolescents are ill. The disease usually develops after 1-3 weeks after a streptococcal infection of the upper respiratory tract: after pharyngitis( inflammation of the pharynx), tonsillitis or tonsillitis( inflammation of the tonsils).
Streptococcal infection does not always manifest itself vividly. Sometimes it proceeds secretly and atypically, with minimal temperature and easy inflammation of the throat, so often in such cases, doctors diagnose ARI and do not perform anti-streptococcal treatment. Meanwhile, an untreated streptococcal infection, especially if it occurs repeatedly and against a background of reduced immunity, can lead to joint rheumatism. And a few days after the angina or pharyngitis, there is inflammation of any large joints: knee, wrist, ankle, elbow and shoulder( minor joints of the fingers or toes are rarely affected by rheumatism).
In this case joints become inflamed in turn .For example, the knee joint first inflames. Then, after a few hours or days, this inflammation disappears, but another joint becomes inflamed, then a third, etc. This kind of alternating "flashing" of the joints is "a hallmark of rheumatism".And the inflammation of the joints is a short-term attack, the duration of which rarely exceeds 10-12 days. But such attacks usually happen a little, and, worst of all, each such attack beats in the end not so much on the joints, but on the heart.
The consequence of not treated rheumatism in time is rheumatic carditis ( rheumatic heart inflammation) most often. Rheumatic heart disease is mild, moderate and severe. The process involves the heart muscle( myocarditis), the heart shell( pericarditis) and heart valves.
In the mild form of the rheumatic carditis , the entire heart is not affected, but only certain areas of the heart muscle. Blood circulation of the heart is not disturbed, external manifestations of the disease are usually absent. This form of the disease occurs most often, and usually goes unnoticed.
With moderate rheumatism , the heart muscle is more affected;the heart is moderately hypertrophied( increases in size).Patients note unpleasant sensations in the chest and behind the breastbone, complain of shortness of breath, increased fatigue when climbing the stairs and walking( even non-fast), a feeling of palpitation with ordinary household loads.
With severe rheumatic carditis , the heart is weakened even more;its dimensions increase significantly. Patients even in complete rest are troubled by pains in the heart, shortness of breath and palpitations;there is swelling on the legs. The severe form of rheumatic carditis very often leads to the appearance of heart defects, that is, to the wrinkling of the heart valves.
In addition to rheumatic carditis, the chorea , a rheumatic nervous system in children, can become a consequence of not treated rheumatism in time. As a result of the chorea, the child or teenager becomes irritable, capricious, absent-minded, slovenly. His handwriting, gait, speech and memory deteriorate, sleep is disturbed. In the early period of illness, parents and teachers are inclined to explain such changes in behavior by the capriciousness and lack of discipline of the child, and the appointment of a doctor is postponed."Beat the bells" parents begin only when the child appears involuntary twitching of the muscles of the face, trunk, hands and feet.
Fortunately, chorea, like rheumatic inflammation of the joints, eventually passes without a trace. And only rheumatic heart disease, if not start treatment on time, can lead to serious disability and early disability of the patient. Therefore, it is important to throw all the forces on the treatment of rheumatism even before he has time to strike his blow to the heart.
Treatment of rheumatism
The main task before us in the treatment of rheumatism is to suppress streptococcal infection, which causes the development of the disease and provokes numerous complications. At present, penicillin( bicillin) and its analogues are most often used from a large group of antibacterial agents for the treatment of rheumatism. Active therapy with penicillin usually lasts about two weeks, and then for five years every three weeks the patient is injected with intramuscular injection of bicillin - to prevent rheumatic heart complications.
In addition to injectable antibiotics( penicillin and bicillin) in recent years, rheumatism has successfully used tableted forms of antibiotics "wide spectrum of action."Very effective in rheumatism, oxacillin, ampicillin, erythromycin, cephalosporin, and a number of other drugs.
Simultaneously with antibiotics in the period of articular attack of rheumatism for the elimination of joint pain, non-steroidal anti-inflammatory drugs are prescribed, which act almost immediately and completely eliminate pain.
Rheumatism is usually treated with antibiotics and non-steroidal anti-inflammatory drugs so well that they are usually enough to completely defeat the disease. Only in rare cases, the action of antibiotics and non-steroidal anti-inflammatory drugs is ineffective. Then you have to resort to extreme measures - prescribe corticosteroid( anti-inflammatory) hormones, which, combined with antibiotics, suppress rheumatic inflammation in just a few days.
Prevention of recurrence of rheumatism
In time to treat rheumatism and stop( stop) his attack - this is only half the battle. It is more important not to allow repeated attacks and exacerbations of the disease. To do this, it is necessary to pay attention to the restoration of the defenses of the body, its immunity, as well as to prevent the possibility of repeated infections with streptococcal infection, to which a person with rheumatic fever previously affected is particularly sensitive. Therefore, all those suffering from rheumatism must necessarily be sent to specialized sanatoriums.
After discharge from the sanatorium, within a year or two from the last rheumatic attack , it is advisable to rest in the summer only in its climatic zone: at the cottage, at rest homes or in sanatoriums( as long trips to other climatic zones involve inevitable acclimatization and dangercomplications).All this time, doctors do not recommend people who have suffered an attack of rheumatism, a lot of sunbathing and a long swim in cold water - cold rivers, lakes, etc. You can swim and sunbathe only so that you do not allow extreme temperature effects on the weakened rheumatism.
It is also undesirable to actively play sports in the first few years after a rheumatic attack. A large physical load leads to an overstrain of the heart weakened by the disease and accelerates its wear. On the other hand, the complete cessation of physical education and ignoring hardening also does not add to health. Therefore, it is still necessary to be trained and engage in physical education, but gradually. When practicing physical education, a man who has suffered rheumatism must control his pulse and breathing. When there is shortness of breath and a heart rate of more than 120 beats per minute, you must always break and rest, and only after the pulse normalization to continue the exercises, but at a slower pace.
In conclusion of this section I want to give the basic rules for the prevention of repeated rheumatic attacks, which are indicated by scientists of the Institute of Rheumatology in the "Book for patients with rheumatic diseases."These are the rules. You need:
- to keep in constant communication with the attending physician;
- follow the doctor's instructions for daily routine, hardening, physical training, treatment and, if possible, avoid participation in those sports games, competitions, hikes that are not allowed by the doctor
- for any acute illness or worsening of health, go to the doctor immediately, and not self-medicate;
- in time to treat sick teeth, chronic inflammation of the tonsils or pharynx;
- in time to put the prescribed prophylactic antibiotic.
And for parents who have recovered from rheumatism the same reference book reminds that the calm and friendly atmosphere in the family will help to strengthen the health of the child. With what I agree to one hundred percent.
Nutrition for rheumatism
To all people who suffer from rheumatism or who have suffered it, doctors recommend it during illness and another year or two after the last attack of rheumatism adherence to diet No. 10. In addition to diet No. 10, there are additional nutrition rules for those patients who have rheumatismis in the active phase, that is, at the time of exacerbation or during a rheumatic attack.
Since the metabolism, especially the water-salt and carbohydrate metabolic processes, is disturbed during the rheumatic attack, all meals are prepared without salt or with a minimum of salt. In addition, you need to limit the use of seasonings containing salt( it should be remembered that even in soy sauce a large amount of sodium salt).It is necessary to exclude from food or to minimize the use of dishes containing extractives - strong meat and vegetable broths and soups, especially soups made of sachets or cooked on the basis of broth cubes. It is necessary to temporarily limit the use of foods containing easily digestible carbohydrates( sugar, jam, jam, honey, confectionery).
Mushrooms, peas, legumes, sorrel and spinach should be practically excluded from food. Of fruits, grapes and grape juice are not recommended. Meat and fish are recommended only in boiled or slightly stewed, and vegetables should be well-cooked.
There is little need, but often - about 5-6 times a day.
In addition, in the acute phase of rheumatism we need to make up for the loss of vitamins caused by increased permeability of the vessels in this disease. In the diet, vitamins C, P, PP, B1, B2, B6, B12 are necessarily added. You can include beers from beer and baker's yeast in the diet, because yeast is a supplier of large doses of natural B vitamins.
The strictest observance of the above nutrition rules must be observed throughout the acute phase of the disease and plus 3-5 days after the end. After exiting the crisis, with good health, you can relax the strict dietary restrictions, but in general, still need to more or less adhere to the above recommendations on nutrition.
Article of Dr. Evdokimenko © for the book "Arthritis", published in 2003.Edited in 2011. All rights reserved.
All articles of Dr. Evdokimenko
All materials on this site are protected by copyright law, being intellectual property of Evdokimenko P. V. Permission is granted to make copies of materials posted on the site solely for non-commercial use. This permission is granted with the following caveats: 1.) you are obliged to indicate that these materials are borrowed by you from the Evdokimenko PV website, 2.) you agree not to change these materials and retain all the instructions contained in them to the author.3) when placing these materials on the Internet, a hyperlink to the site evdokimenko.ru is required. For commercial use of these materials, please contact Evdokimenko P.V.on the contact telephone numbers indicated on the site.