Rheumatism: symptoms, treatment and consequences

The timely determination in the early stages of the signs of any disease is an important condition for its effective treatment, especially if there is a predisposition to this ailment. The same applies to a disease such as rheumatism.

Also important is the correct diagnosis, which is carried out using diagnostics by various methods. In this article, we consider what are the symptoms of rheumatism, a variety of the disease, its treatment and prevention.

The concept of rheumatism

In modern medical sources, rheumatism is an inflammatory disease of a systemic nature of the connective tissue, the pathological process of which is localized mainly in the membranes of the heart muscle or in the periarticular soft tissues, but can also affect other organs.

Most often, this disease occurs in children. The younger the child, the worse the relapse of the disease. It is necessary to identify symptoms on time, and the treatment of rheumatism in children in this case will be more effective.

Rheumatism can occur in such varieties:

• rheumatic heart disease - an inflammatory lesion of all membranes of the heart muscle, including the myocardium;
• rheumopleuritis - damage to the respiratory organs;
• skin rheumatism - inflammation of the skin;
• rheumatic fever - a pathology manifested by vasculitis of the small vessels of the brain (more often in girls);
• rheumatoid arthritis - inflammation of the joints.

With rheumatism, the digestive system is relatively rarely affected. In this case, acute pains in the abdomen may appear, which are associated with rheumatic peritonitis. Sometimes inflammation of the liver or kidneys occurs.

The danger of the disease is that if you ignore the symptoms of rheumatism and treatment, as well as systematic observation by a doctor, serious pathologies of the central nervous system and heart can develop.

Causes of the disease

An important role in the occurrence of the disease is played by a genetic predisposition.

Most often, the symptoms of rheumatism make themselves felt one to three weeks after the following events:

• ingestion of group A β-hemolytic streptococcus;
• exacerbation of chronic forms of tonsillitis, pharyngitis, tonsillitis, otitis media;
• scarlet fever disease;
• puerperal fever.

The body of ninety-seven percent who have had streptococcal infection forms a stable immunity. The rest, with repeated infection, develop an inflammatory reaction.

The main factors that contribute to the onset of symptoms of rheumatism (photo manifestations can be seen in the article), consider:

• reduced immunity;
• collectives with a large number of people (schools, dormitories and others);
• children's and young age;
• negative social conditions of existence;
• prolonged hypothermia.

Clinical manifestations of rheumatic heart disease

This kind of rheumatism is dangerous because in twenty percent of cases it can end with a formed heart disease. And if adults are able to clearly describe the manifestations of the disease, then children, as a rule, do not pay attention to them.

Symptoms of heart rheumatism are as follows:

• weakness, fatigue, headaches;
• excessive sweating;
• a sharp decrease in appetite;
• stitching pains in the region of the heart;
• temperature increase over 38 degrees Celsius;
• slight decrease in pressure;
• heart palpitations;
• severe symptoms of heart failure and cardiac arrhythmias.

It is extremely important to identify the symptoms of heart rheumatism on time - treatment of the disease in this case will be more effective.

Clinic of articular rheumatism

The joint form of acute rheumatism usually begins 1-3 weeks after a sore throat or other infectious disease (flu, inflammation of the ear or paranasal sinuses). Moreover, as a rule, children and youth suffer. Symptoms and treatment of joint rheumatism will be discussed later.

Patients complain about the following symptoms:

• severe pain in the joints, more often in large - shoulder, knee, ankle and others;
• swelling in the joints;
• impossibility of movement due to pain of a volatile nature;
• temperature rises to 38-39 ° C;
• there is severe sweating (especially severely sweating at night and early in the morning);
• the lesion appears symmetrically;
• there is weakness, weakness, bleeding from the sinuses.

More often the disease begins acutely, less often - it develops gradually. When examining patients, their stationary position is noteworthy - they avoid the slightest movements due to sharp pains in inflamed places. Symptoms of rheumatism of the hands are similar to the manifestations of other types of disease.

Usually the affected joints are enlarged, the skin above them is slightly hyperemic, hot to the touch, moist, sometimes covered with an erythematous rash.

In the early days of the cardiovascular system, in addition to moderate tachycardia, no changes were noted. Joint pains are volatile, and more often it manifests itself in young, strong people. The defeat of each new joint occurs within a few hours.

Symptoms of rheumatism in adults are manifested as follows: first, one or two joints are affected, then more and more new ones are involved. In some cases, eight joints can be inflamed at once, and sometimes more.

In severe cases, edematous fluid accumulates not only in the articular cavity, but also in the periarticular muscles and connective formations. When feeling them, the most painful places are the attachment of fibrous fascia and tendons to the bones.

It should be emphasized that joint pains can become inflamed after a few days, so that some of them can be affected several times during acute rheumatism. This is especially true for rheumatism of the legs - the symptoms are similar to the general manifestations of other types of disease.

Clinic of other forms of rheumatism

Each type of rheumatism has its own characteristic features. Let's consider them further.

Rheumochorea is characterized by such signs:

• violation of fine motor skills, handwriting, coordination of movements - symptoms appear only during wakefulness;
• the occurrence of spontaneous grimaces, muscle weakness, the inability to walk and sit;
• violation of swallowing;
• the patient’s behavior changes in the direction of instability and variability - from aggressiveness and emotional instability, the patient goes to distraction, passivity, he quickly gets tired.

The skin form of the disease is manifested by the following symptoms:

• erythema nodosum is characterized by a limited compaction of skin areas (mainly on the lower extremities) with a color change to dark red, the size is from half a centimeter to four;
• annular erythema is characterized by painless pale pink rashes in the form of ring-shaped rims;
• the occurrence of dense, painless rheumatic nodules ;
• in rare cases, with severe capillary permeability, small capillary hemorrhages may appear;
• pale skin;
• excessive sweating.

Nodules do not cause discomfort and disappear within two to three weeks.

It is important to know what symptoms of rheumatism occur in order to consult a specialist in time to determine the type of disease.

Rheum pleuritis is characterized by the following symptoms:

• increase in body temperature;
• pain in the sternum when breathing, more severe when inhaling;
• dry cough;
• severe shortness of breath;
• breath is not heard on the affected side.

Symptoms of rheumatism in adults are manifested mainly similar to childhood.

Diagnosis of the disease

For the timely detection of the disease, it is necessary to consult a doctor in time, who will conduct the necessary examination. Its results will help establish the correct diagnosis and prescribe treatment. Symptoms of rheumatism in the hands, as well as other varieties of the disease, are similar in nature, and therefore require careful analysis.

For diagnosis, laboratory and instrumental studies are performed.

The first group includes:

1. Blood analysis. The presence of a disease is indicated by the appearance of C-reactive protein, an increase in ESR, anemia, and a shift in the leukocyte formula to the left. The result helps determine the degree of activity of the disease. The analysis also determines eosinophilia and anemia.
2. Joint fluid analysis. The result determines whether serous fibrinous exudate is present with a large number of endothelial cells, neutrophils, single red blood cells, and fibrin flakes.
3. Analysis of pleural fluid. Shows the presence of a similar exudate containing a large number of mesothelial cells.
4. Smear. Analysis with a large number of segmented neutrophils and lymphocytes, as well as neutrophils.
5. Analysis of urine. The disease confirms the presence of traces of protein and red blood cells.
6. The diphenylamine (DFA) test determines an increase in the level of mucoproteins, titers of antistreptokinase, antistreptolysin and antigialuronidase.

Instrumental studies include:

1. Electrocardiogram - shows a violation of the rhythm of the heart muscle.
2. Ultrasound examination of the heart.
3. FKG - determines the change in noise and heart sounds.
4. X-ray - allows you to measure the dynamics of the size of the heart muscle, its configuration and contractile function.

Course of the disease

The course of the active form of rheumatism is quite long, although joint damage is often relatively quickly eliminated - from two to three weeks to three to six months.

Even with mild symptoms of rheumatism, the process in the heart and joints is invisible to the patient and often for the doctor continues inexorably. The tragedy of a patient with rheumatism is that during this period his joints do not bother him, discomfort in the heart area is very slight, his health improves, so people stop taking the necessary drugs. When after a few years, patients seek medical help, the results of an objective study indicate that they have a pronounced heart disease with the presence of endocarditis and inflammation of the circulatory system.

The most serious changes occur from the cardiovascular system. With rheumatism, the myocardium, endocardium and pericardium are affected. First of all, changes occur in the heart muscle. Clinically, seven to ten days after the onset of the disease, in the midst of joint pain, patients have a rapid heartbeat, shortness of breath, heaviness, discomfort and pain in the heart.

The symptoms of rheumatism in children at the initial stage are sometimes difficult to determine, because the child cannot describe them correctly. Therefore, adults should pay attention to obvious signs in the form of temperature, a weakened state, joint swelling.

The following degrees of the disease are distinguished, depending on how severe the clinical symptoms of rheumatism are:

• sharp, continuously manifested;
• subacute (moderate activity);
• latent, that is, sluggish, having minimal activity.

Rheumatism is characterized by repeated attacks - relapses resulting from external adverse effects: hypothermia, infections, physical stress. Clinical signs of repeated inflammation resemble primary, but they are less pronounced, but the symptoms of heart damage, on the contrary, prevail.

Differential diagnosis of articular rheumatism

In severe cases, doctors have no difficulty in making a diagnosis, especially taking into account the pathology of the patient’s heart.

First of all, it is necessary to distinguish rheumatoid arthritis from rheumatoid (non-specific, infectious). The similarity of these diseases lies in the fact that both of them can begin with the onset of a sore throat or damage to the adnexal nasal cavities, and an increase in temperature.

In addition to rheumatoid arthritis, rheumatoid arthritis should be differentiated with infectious specific polyarthritis of a particular etiology. This should be borne in mind tuberculosis, gonorrhea, brucellosis, dysentery, syphilis, influenza, typhoid fever, sepsis and acute childhood infections.

Prognosis and primary prevention

The prognosis for the articular form of rheumatism is determined by the degree of damage to the heart.

Changes in the joints themselves most often end favorably, and residual changes in the form of tight mobility or ankylosis are rare.

With the timely detection of symptoms and treatment of rheumatism, the disease lends itself well to therapeutic effects. The most difficult and unfavorable is the frequently recurring rheumatism.

Great importance should be given to the living conditions in which the patient will have been ill with the primary or acute form of the disease. It is important to combat cooling, dampness, drafts, overwork to prevent relapse of rheumatism.

Widespread preventive measures for treating the symptoms of rheumatism in the joints include hardening of the body to increase its resistance to cooling, fluctuations in external temperature, and dampness. Physical education and sports exercises will contribute to the necessary training and hardening of the body.

Drug prophylaxis and treatment of concomitant ailments

The detection of all kinds of chronic infectious foci in the body requires immediate treatment. Sanitation of the oral cavity, removal of carious teeth, treatment of chronic tonsillitis, inflammation of the ear and accessory cavities of the nose are necessary.

The presence of chronic inflammatory foci can not only contribute to the widespread spread of infection in the body, increase allergic reactions, but also change its reactivity and thereby create conditions for the occurrence of rheumatism.

One of the methods that allow the clinician to clarify the presence of allergies is the study of peripheral blood. An increase in the number of eosinophils over five percent should always attract attention and give rise to a thorough examination of the body, and if necessary, to the use of desensitizing agents (diphenhydramine, diazolin, calcium chloride and others).

As preventive measures during periods of exacerbation - in the spring and in the fall - they conduct antimicrobial and anti-inflammatory drug therapy.

Secondary prevention

For secondary prevention, the following measures are characteristic:

1. With the active course of the disease, constant monitoring of the condition by a rheumatic cardiologist is necessary. At first, it is visited monthly for three months from the detection of symptoms of rheumatism, and after - once a quarter. It is also mandatory to seek the advice of such specialists as a neurologist, ENT specialist, optometrist, dentist, gynecologist.
2. A necessary rule is the delivery of blood plasma once every two months, and urine once a quarter.
3. Quarterly diagnostic measures.
4. Four times a year they donate blood for rheumatic tests.
5. With a decaying process and its transition to an inactive form, a rheumatic cardiologist is visited from two to four times a year.

Rheumatism treatment

The active and acute phase of rheumatism is treated in a hospital with patients strict bed rest.

Patients are prescribed medications with hyposensitizing and anti-inflammatory effects: non-steroidal anti-inflammatory drugs, corticosteroid hormones. Also, in the presence of infectious foci, antibiotics are prescribed with their simultaneous debridement (carious teeth, tonsillitis, sinusitis).

In parallel with the main drug therapy, patients are prescribed immunomodulators and sedatives. With revealed heart lesions, diuretics and cardiac glycosides are used.

Symptoms and treatment of rheumatism in adults in the general case does not differ from therapy in children.

In an outpatient setting:

• patients should observe strict bed rest and be in a warm, dry room, in a calm environment;
• it is necessary to provide good nutrition with a sufficient amount of vitamins (A, C, B1);
• it is recommended to introduce a sufficient amount of protein and carbohydrates with food;
• you should limit the intake of salt (up to 3-4 g), which really has a positive effect on the course of the inflammatory process;
• due to patient sweating, fluid intake should not be limited.

With a weakening form of the disease from medications, the use of salicylates in the form of salicylic sodium or aspirin, as well as antibiotics (penicillin) should be in first place. Instead of salicylic sodium, aspirin can be prescribed, but its effect will be slightly weaker.

Also used hormonal drugs - ACTH, cortisone and its derivatives. , .

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