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Rheumatism of joints
March 14, 2012
Rheumatism – an illness of infectious and allergic character which affects connecting fabric both in cardiovascular system, and in skin, joints, muscles, internals. As a rule, rheumatism affects the person in the childhood and at youthful age. It is considered that the hemolitic streptococcus acts as a disease-producing factor, however the main factor promoting development of rheumatism is the allergy. So, very often rheumatism arises at the person as an effect of quinsy, acute inflammatory processes in upper respiratory tracts, accompanies caries of teeth. Also developing of rheumatism is promoted by overcooling, long stay on dampness.
Rheumatism of joints (other name — rheumatic polyarthritis) is a disease which development can happen in an organism imperceptibly for the person, however his effects will be the most serious. It is for some reason considered to be that rheumatism of legs and joints affects mainly elderly people. But practice demonstrates that most often rheumatism of joints is observed at children from 7 to 15 years. If to consider the number of patients with rheumatism in general, then about 80% of adult patients are people who were not forty years old yet.
Reasons of rheumatism of joints
Very often rheumatism of joints develops at those people whose relatives already had cases of display of this illness. Also people who often have infectious diseases, and also in what organism there is a special protein of group B have rheumatism. It is noticed that more often rheumatism of joints arises at women. Strong attacks of rheumatism are shown during the cold period of year, overcooling becomes frequent one of the factors provoking an illness.
The postponed earlier streptococcal infection becomes a cause of illness. The inflammation of connecting fabric of a number of bodies becomes its effect in this case. According to researches, rheumatism of joints is shown as allergic reaction to process of infection of an organism with one of beta and hemolitic streptococci of group A. Quinsy, chronic pharyngitis, scarlet fever, tonsillitis, an inflammation of a middle ear, etc. become the diseases preceding rheumatism of joints often.
At hit in a human body of a streptococcus immune system it is strengthened fights against the causative agent of diseases, and at the same time begins to produce specific antibodies. Property to find streptococci on certain molecules is characteristic of such antibodies. The people inclined to rheumatism of joints have same molecules. As a result, own organism is exposed to attack of antibodies. As a result at the person inflammatory processes in connecting fabric are shown. Owing to such processes there is also rheumatism of heart, joints, etc. the Person cannot have immunity to an infection therefore at repeated infection there are also repeated attacks of rheumatism of joints. Sometimes also genetic predisposition is the reason of display of this illness.
Symptoms of rheumatism of joints
If at the person rheumatism develops, symptoms begin to be shown about enough sharp pain in joints. As a rule, defeat first of all happens in large joints. Very often is surprised talocrural, knee, elbow, radiocarpal, humeral joints. At damage of a joint there is its reddening, to the touch it becomes hot. If at the patient further progressing of rheumatism is observed, symptoms amplify: joint pains become even more intensively, often the patient cannot move and even to touch a joint. Rheumatism of joints proceeds very painfully. Also at the person increase of body temperature is observed: often it rises to 39 ° and even to 40 °.
Only in rare instances rheumatism affects on one joint: more often the illness develops in several joints at once. In this case the rheumatic attack is shown as follows: at first the aggravation is observed in one joint, but in several hours pain in this joint becomes less intensive, the swelling and reddening decreases a little. However similar changes are observed at that time already in other joint. Thus, at development of this form of rheumatism symptoms have "flying" character. If treatment of rheumatism begins at once after manifestation of its first signs, the disease can be suspended. As a result, only two will be involved in pathological process or three joints. Otherwise, in the absence of due therapy over a long time the patient will have a defeat all of new joints. Gradually the disease can extend to all joints of extremities, sometimes it affects also joints of a backbone and a mandible. In that case the person should suffer from very severe pain in the course of meal.
Pain at patients with rheumatism is often shown sharply and unexpectedly disappears. At the same time there is no deformation of the affected joint, disease mainly high-quality. Pains can sometimes have the migrating character. The inflammation of joints, as a rule, proceeds about one week.
According to supervision of specialists which deal with a problem of treatment of rheumatism of joints most often people have a damage of those joints which the person in the course of professional activity or everyday work loads most of all. Also rheumatism quite often affects joints which were injured earlier, that is were exposed to frequent overcooling, bruises, pressure, and also other negative impacts. For example, rheumatism of legs is often shown at people who go much or run.
However at rheumatism of joints there is not always a manifestation of so noticeable symptoms of a disease. If attacks of rheumatism occur repeatedly, then the beginning of an illness will be not so acute. Most often symptoms of rheumatism are less expressed at elderly people: pain is not so intensive, the person can move a joint, fervescence also insignificant. In certain cases people in a similar state even continue to work and do not ask for the help the specialist.
If joint attack proceeds so inertly, then at the person repeated exacerbations of a disease at which pains amplify are, as a rule, observed. In general rheumatism of joints lasts till some months.
Complications of rheumatism of joints
At the same time at the person also the rheumatic carditis is often shown. In this case changes in an organism can be insignificant, that is such which diagnose only in the course of special inspection. But regarding cases severe defeats at which the patient feels strong heartbeat, suffers from hypostases, an asthma, pain in heart take place. The rheumatic carditis is most often shown at people in 12-25 years.
The disease constitutes danger from the point of view of its influence on heart valves. In the course of its development heart valves shrivel, lose elasticity and as a result collapse. As a result there is a deformation of valves: they either do not reveal completely, or are closed not rather densely. Therefore valve defect can be complication of rheumatism of heart and rheumatism of joints.
Also defeat of a nervous system which is most often shown at children can become complication of rheumatism. As a result the child becomes very irritable, whimsical, often scattered. Later problems with memory can be found in the sick child, character of the speech, gait changes.
In certain cases rheumatism is shown by an anulyarny erythema. On skin ring-shaped rashes, under skin – so-called rheumatic small knots painfully appear. However this form of complication meets less often.
Diagnosis of rheumatism of joints
Implementation of diagnosis of rheumatism is based on existence of a number of clinical signs of defeat of certain bodies, and also on results of laboratory analyses. At an acute phase of rheumatism of joints in blood the neutrophylic leukocytosis is, as a rule, observed, in the first days of a disease hemoglobin level can decrease and if palindromias repeat often, then display of anemia is possible. Also some other the changes characteristic of this disease is observed.
Also for diagnosis of damage of heart to the patient carrying out an ECG or ultrasonic research of heart is appointed.
Treatment of rheumatism of joints
That treatment of rheumatism of joints conceived the maximum success, it is necessary to address for consultation of the doctor at once after emergence of suspicion on rheumatism of joints. Efficiency of treatment depends on many factors: first of all, it is important to choose correctly means and methods of treatment, and also to observe all recommendations of the attending physician. So, it is important to adhere to a bed rest, to observe the general rest, to be in the pure, well aired room. The patient has to observe a bed rest until activity of an inflammation does not begin to fall down. Some specialists also advise to reduce amount of the eaten carbohydrates and to increase amount of proteins.
In the course of treatment of rheumatism of joints doctors often appoint a number of different means, being guided by the principle of complex treatment. So, before disappearance of symptoms of pronounced inflammatory process the attending physician can appoint a course of antibiotics. In view of the streptococcal nature of rheumatism therapy is carried often out by penicillin. Also sick non-steroidal anti-inflammatory drug is appointed. Treatment by penicillin to last for 10–14 days. Depending on specific features sometimes duration of treatment increases, or other antibiotic is appointed. Non-steroidal anti-inflammatory drug should be accepted, at least, for a month, till that time until all symptoms of active rheumatism of joints disappear.
Parallel to the patient appoint reception of immunodepressants, glucocorticoids, and also gamma-globulins for the purpose of strengthening of protective functions of an organism.
After the acute state at rheumatism of legs and joints is removed, to the patient is shown to complete a course of physiotherapeutic procedures. Often in the course of treatment of rheumatism the electrophoresis, UVCh, warming up by a lamp of infrared beams, paraffin applications is used.
If attacks of rheumatism are observed at the patient throughout a long time, to it can appoint procedure of a plazmoforez (purification of blood). By means of this method blood is purified of different toxins and antibodies.
At the correct approach to treatment morbidity and hypostases of joints pass at patients in most cases one-two weeks later. But if the patient sees a doctor immediately, then the attack of rheumatism can end in several days.
In need of process of treatment of rheumatism of heart and joints also elimination of the reasons of chronic infection, for example, removal of almonds is carried out.
Prevention of rheumatism
As the prevention of rheumatism measures of primary and secondary prevention are applied. For primary prevention of rheumatism, first of all, it is necessary to take all measures for immunity increase. For this purpose it is necessary to practice a hardening, to have regular good rest, to prefer healthy food. The person at whom symptoms of infectious diseases are observed needs to ask for the help of the doctor immediately. The correct approach to treatment of both an acute, and persistent streptococcal infection is important.
The methods of prevention of rheumatism mentioned above at children in those families where cases of rheumatism of heart, joints and other bodies were recorded are not less important. Preventive measures should be applied to children who often have a nasopharyngeal infection or an adenoid disease.
Measures of secondary prevention of rheumatism are directed to warning palindromias and progressing of rheumatism at patients who at the moment consist on dispensary accounting in connection with the postponed rheumatism.