Acute rheumatism and rheumatoid arthritis

Clinical manifestations involve a prodromal stage, a latency period and a period of condition. • Prodromal stage - streptococcal angina with dysphagia (difficulty in swallowing), adenopathy (enlarged lymph nodes), subfebrility, erythematous appearance (red). • Latency - after 1-3 weeks, manifestations of acute articular rheumatism. The patient loses weight, has (nasal bleeding), and shows the elongation of the PR interval on the ECG. • Stage periodA. General manifestationsThe most important manifestation is fever (39-40 degrees Celsius) which can last from a few weeks to several months.

Fever is climbing with the joints. Aspiration-free fever indicates visceralisation, that is, holding the heart (heart). Pulse is consistent with fever. If the fever grows, the pulse also increases. Normal temperature accompanied by increased pulse indicates visceralization.

The abnormally ill, especially at night, which exhausts it. Sweating has a very sour and prickly scent. Two other important symptoms are: (headache) and dizziness. B. Joint manifestations These are changes in acute inflammation of the large joints (knees, ankles, elbows, shoulders).

The joints are red, they become painful and hot and swell. Inflammation has a fugitive character, meaning it passes from one joint to another. The articular joint takes about three weeks. C. Cardiovascular manifestations affect all three layers of the heart (endocardium, myocardium, pericardium) causing myocarditis and pericarditis.

This ensemble of manifestations is called rheumatic pancarditis; . Pulmonary manifestations - consist of pleurisy and E. Nerve manifestationsSpecific for acute articular rheumatism, sydenham syndrome, ie involuntary, irregular, spontaneous body movements, accompanied by grimaces, exarcerbates of effort, which reduce sleep. F. Skin manifestationsBeep so-called Meynet nodules, located in the cervical region and around the affected, red and painful joints, which last for three to four days and are a sign of cardiac and poor prognosis.

There may be lesions of marginal erythema that are pink spots on the skin of the chest. They have a pale center and are unprime (do not eat). On the anterior face of the shank, there may be areas of nodular erythema (pink lesions with nodules). In any disease, in addition to clinical manifestations, laboratory and paraclinical manifestations must be known to establish a correct diagnosis and treatment. In the case of acute articular rheumatism, the following changes will occur: • Nonspecific (fibrinogen, C reactive) inflammatory samples - indicating the presence of inflammation • Pharyngeal exudate - indicates the presence of group A beta-hemolytic streptococcus • ASLO titre .

In acute articular rheumatism, the positive diagnosis is somewhat different, using the Jones-Ducke criteria: Major criteria • Carditis • Cutaneous nodules • Erythematous margin. Minor criteria (joint pain) • Fever • Nonspecific positive inflammation samples • Increased PR interval on ECG • History • History of acute articular rheumatism or rheumatic cardiopathy. The positive diagnosis is established when either two major criteria coexist, or a major criterion with two minor criteria. is a immune disease localized especially in small joints, symmetrical, leading to deformations and ankylosis. It occurs especially in women between 25 and 50 years of age.

There are three stages in the symptomatic picture of rheumatoid arthritis: the prodromal stage, the latency stage and the manifest clinical stage. 1. The prodromal stage is manifested by asthenia, adynamics, localized joint pain at the small joints accompanied by cramps and muscle aches. Muscle pain occurs especially in the morning and gives up about an hour after mobilization. 2.

The debut stageThe pain attacks the joints between the phalanges and the fist joint. Swelling of these joints occurs with character. 3. Clinical stage manifestIn this stage we can talk about articular and extraarticular symptoms. Symptoms of the joint - are continuous pain, predominantly morning, with subsequent limb of joint movements, with functional impotence and then with ankylosis.

Fingers take the form of the letter \. After the joints of fingers and fists, the knees, elbows and ankles are attached. Extra-articular symptoms consist of: - atrophies and muscle contractions, - thin, fine skin, velvety skin, - body-shaped egg-shaped nails, - depigmented, - subcutaneous, strong, painless subcutaneous nodules. In order to establish the diagnosis of rheumatoid arthritis, the physician mainly uses three types of laboratory tests: • Nonspecific inflammation (VSH, fibrinogen) - become positive in rheumatoid arthritis • Waaler-Rose test • Latex test. The Waaler-Rose test and the latex test investigate the immune conflict underlying the disease.

• In the synovial fluid (which hugs the joint) it can be highlighted a ragout, which is a leukocyte that has involved an antigen-antibody complex. There is another element that highlights the immune status of the disease. .