Rheumatism - An infectious-allergic disease that affects the connective tissue both in the cardiovascular system and in the skin, joints, muscles, internal organs. As a rule, rheumatism affects a person in childhood and adolescence.
It is believed that the causative agent of the disease actshemolytic streptococcusHowever, the main factor contributing to the development of rheumatism is allergy. So, very often rheumatism occurs in humans as a consequence sore throatsacute inflammatory processes in the upper respiratory tract, accompanies tooth decay. Also, the occurrence of rheumatism contributes to hypothermia, a long stay on damp.
Joint rheumatism (other name - rheumatoid arthritis) is a disease the development of which can occur in the body unnoticed by humans, but its consequences will be most serious. For some reason, it is generally accepted that rheumatism of the legs and joints affects mainly the elderly. But practice shows that most often rheumatism of joints is observed in children from 7 to 15 years. If we consider the number of patients with rheumatism in general, then about 80% of adult patients are people who are not yet forty years old.
Causes of rheumatism of joints
Very often, rheumatism of the joints develops in those people whose relatives have already had cases of this disease. People who often suffer from infectious diseases, as well as those in whose body there is a special protein of group B, also suffer from rheumatism. It is noticed that more often rheumatism of joints occurs in women. Severe attacks of rheumatism occur in the cold season, because it is hypothermia that often becomes one of the factors that provoke the disease.
The cause of the disease becomes previously transferred streptococcal infection. Its consequence in this case is inflammation of the connective tissue of a number of organs. According to studies, rheumatism of the joints manifests itself as an allergic reaction to the process of infection of the body by one of group A beta hemolytic streptococci. Diseases prior to rheumatism of the joints often become angina, chronic pharyngitis, scarlet fever, tonsillitis, middle ear inflammation and etc.
When streptococcus enters the human body, the immune system intensifies its fight against the causative agent of diseases, and at the same time begins to produce specific antibodies. Such antibodies are characterized by the property of finding streptococci by specific molecules. These same molecules are in people prone to rheumatism of the joints. As a result, the body is attacked by antibodies. As a result, a person has inflammatory processes in the connective tissue. As a result of such processes, rheumatism of the heart, joints, etc. occurs. A person cannot be immune to infection, therefore, with repeated infection, repeated attacks of rheumatism of the joints occur. Sometimes the cause of this ailment is also a genetic predisposition.
Symptoms of rheumatism in the joints
If a person develops rheumatism, the symptoms begin to appear with a rather sharp pain in the joints. As a rule, the lesion primarily occurs in large joints. Very often amazed ankle, knee-, ulnar, wrist, shoulder joints. When the joint is affected, its redness occurs, it becomes hot to the touch. If the patient has a further progression of rheumatism, the symptoms intensify: the pain in the joint becomes even more intense, often the patient cannot move and even touch the joint. Joint rheumatism is very painful. Also, a person has an increase in body temperature: often it rises to 39 ° and even to 40 °.
Only in rare cases, rheumatism affects one joint: more often, the disease develops in several joints at once. In this case, a rheumatic attack manifests itself as follows: first, an exacerbation is observed in one joint, but after a few hours the pain in this joint becomes less intense, the swelling and redness slightly decrease. However, such changes are observed at that time already in another joint. Thus, with the development of this form of rheumatism, the symptoms are “volatile” in nature. If the treatment of rheumatism begins immediately after the manifestation of its first signs, the disease can be stopped. As a result, only two or three joints will be involved in the pathological process. Otherwise, in the absence of proper therapy for a long time, the patient will experience damage to all new joints. Gradually, the disease can spread to all joints of the limbs, sometimes it also affects the joints of the spine and lower jaw. In this case, the person has to endure very severe pain during the meal.
Pain in patients with rheumatism often manifests itself sharply and suddenly disappears. In this case, deformation of the affected joint does not occur, because the course of the disease is mainly benign. Sometimes the pain can be migratory in nature. Joint inflammation usually lasts about one week.
According to the observations of specialists who deal with the problem of treating rheumatism of joints, most often in people there is a defeat of those joints that a person burdens most in the process of professional activity or everyday work. Also, rheumatism often affects joints that were previously injured, that is, were subjected to frequent hypothermia, bruises, pressure, as well as other negative effects. For example, rheumatism of the legs is often manifested in people who walk or run a lot.
However, with rheumatism of the joints, the manifestation of such noticeable signs of the disease does not always occur. If bouts of rheumatism occur repeatedly, then the onset of the disease will not be so acute. Most often, the symptoms of rheumatism are less pronounced in older people: the pain is not so intense, the person can move the joint, the increase in body temperature is also insignificant. In some cases, people in this state even continue to work and do not seek help from a specialist.
If the joint attack proceeds so sluggishly, then a person, as a rule, has repeated exacerbations of the disease, in which pain intensifies. In general, rheumatism of the joints lasts several months.
Joint rheumatism diagnosis
The diagnosis of rheumatism is based on the presence of a number of clinical signs of damage to certain organs, as well as on the results of laboratory tests. In the acute phase of rheumatism of joints in the blood, as a rule, is observed neutrophilic leukocytosis, in the early days of the disease, the level may decrease hemoglobin, and if relapses of the disease are repeated often, then a manifestation is possible anemia. There are also a number of other changes characteristic of this disease.
It is important to conduct differential diagnosis with non-specific infectious polyarthritis-septic endocarditis, tuberculosis, neurosis and other diseases.
Also, to diagnose heart damage, the patient is prescribed an ECG or ultrasound of the heart.
Joint rheumatism treatment
In order for treatment of rheumatism of joints to be maximally successful, it is necessary to seek the advice of a doctor immediately after a suspicion of rheumatism of the joints. The effectiveness of treatment depends on many factors: first of all, it is important to choose the right means and methods of treatment, as well as follow all the recommendations of the attending physician. So, it is important to adhere to bed rest, to observe general peace, to be in a clean, well-ventilated room. The patient should observe bed rest until the activity of inflammation begins to subside. Some experts also advise reducing the amount of food consumed. carbohydrates and increase the amount protein.
In the process of treating rheumatism of the joints, doctors often prescribe a number of different drugs, guided by the principle of complex treatment. So, until the symptoms of a pronounced inflammatory process disappear, the attending physician can prescribe a course antibiotics. Due to the streptococcal nature of rheumatism, therapy is often carried out penicillin. Also, the patient is prescribed a non-steroidal anti-inflammatory drug. Penicillin treatment lasts for 10-14 days. Depending on individual characteristics, sometimes the duration of treatment is increased, or another antibiotic is prescribed. A non-steroidal anti-inflammatory drug should be taken for at least a month, until all signs of active rheumatism of the joints disappear.
In parallel, the patient is prescribed immunosuppressants, glucocorticoids, as well as gamma globulin in order to strengthen the protective functions of the body.
After the acute condition with rheumatism of the legs and joints is removed, the patient is shown to undergo a course of physiotherapy procedures. Often in the process of treating rheumatism, electrophoresis, UHF, a lamp warming up infrared rays, paraffin baths are used.
If bouts of rheumatism are observed in a patient for a long time, he may be prescribed a procedure plasmophoresis (blood purification). Using this method, the blood is cleaned of various toxins and antibodies.
With the right approach to treatment, pain and swelling of the joints disappear in patients in most cases after one to two weeks. But if the patient goes to the doctor immediately, then the rheumatism attack can end in a few days.
If necessary, the treatment of rheumatism of the heart and joints also removes the causes of chronic infection, for example, removal of the tonsils.
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As a prevention of rheumatism, primary and secondary prevention measures are used. For the primary prevention of rheumatism, first of all, it is necessary to take all measures to increase immunity. To do this, you need to practice hardening, have a regular good rest, prefer a healthy diet. A person who has symptoms of an infectious disease should immediately seek medical help. The correct approach to the treatment of both acute and chronic streptococcal infections is important.
No less important are the above-mentioned methods for the prevention of rheumatism in children in those families where cases of rheumatism of the heart, joints and other organs have been recorded. Preventive measures should be applied to children who often suffer from a nasopharyngeal infection or chronic tonsillitis.
Measures of secondary prophylaxis of rheumatism are aimed at preventing relapse of the disease and the progression of rheumatism in patients who are currently under medical supervision in connection with the transferred rheumatism.
Complications of rheumatism of joints
At the same time, a person often manifests and rheumatic heart disease. In this case, changes in the body may be minor, that is, those that are diagnosed only in the process of a special examination. But in some cases there are severe lesions in which the patient feels a strong heartbeat, suffers from edema, shortness of breathpain in the heart. Rheumatic heart disease most often occurs in people aged 12-25.
The disease is dangerous in terms of its effect on heart valves. In the process of its development, heart valves shrink, lose their elasticity and eventually collapse. As a result, the valves are deformed: they either do not open completely, or close not tight enough. Therefore, valve disease can be a complication of rheumatism of the heart and rheumatism of the joints.
Also, a complication of rheumatism can be damage to the nervous system, which is most often manifested in children. As a result, the child becomes very irritable, moody, often absent-minded. Later, a sick child may have memory problems, the nature of speech, gait changes.
In some cases, rheumatism is manifested. ular erythema. Ring-shaped rashes painfully appear on the skin, the so-called rheumatic nodules under the skin. However, this form of complication is less common.
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List of sources
- Clinical recommendations. Rheumatology. Ed. E.L. Nasonova, M., TEOTAR-Media, 2005.
- Nikonova L. B., Fatikhov R.G. Rheumatoid arthritis: problems of microcirculation and peripheral blood flow. Differentiated physical therapy. - Kazan, 2001.
- Mazurov V.I., Smulskaya O.A. Rheumatism (acute rheumatic fever) // Clinical rheumatology. St. Petersburg: Tome, 2001.