Rheumatism is an inflammatory disease of connective tissues, mainly in the cardiovascular and musculoskeletal systems. The main danger of rheumatism is that in the absence of appropriate treatment and observation by a specialist, it is possible to develop serious pathologies that affect the central nervous system and disrupt cardiovascular activity, which can lead not only to a deterioration in the quality of life in general, but also to disability and loss of ability to work.
Rheumatism: what is it?
Rheumatism is a systemic inflammatory disease that is mainly localized in the lining of the heart. At risk are people who have a hereditary predisposition to this disease and are between 7 and 15 years of age. Rheumatism usually affects adolescents and young people, less often elderly and weakened patients.
Rheumatism (synonyms: rheumatic fever, Sokolsky-Buyo disease) is chronic, with a tendency to relapse, exacerbations occur in spring and autumn. Rheumatic lesions of the heart and blood vessels account for up to 80% of acquired heart defects.
In the rheumatic process often get involved joints, serous membranes, skin, central nervous system. The incidence of rheumatism ranges from 0.3% to 3%.
Hereditary predisposition to this disease plays a huge role. In so-called rheumatic families, the incidence is three times higher than in the general population. The disease is inherited in a polygenic manner.
Classification
Highlight:
Acute rheumatism
Rheumatism in the acute phase most often manifests itself in young people under 20 years of age. The causative agent is streptococcus. The association of the disease with previous infections of the upper respiratory tract consists of a delayed onset of symptoms (14-21 days).
The initial manifestations of rheumatism have much in common with the clinic of colds, but after a short period of time, manifestations of carditis, skin rashes and polyarthritis join the symptoms of a cold.
The total duration of the acute form of the disease is from 3 to 6 months. Acute form rheumatism can lead to the development of serious complications. In the absence of timely treatment, rheumatic carditis develops into heart defects.
Chronic rheumatism
The chronic form of rheumatism is characterized by frequent relapses of the disease, especially when the body is hypothermic. The heart and joints are most often affected, with typical pain in these organs. The course of the disease can last for several years.
Rheumatism is divided into forms according to the criterion of the affected system or organ:
- Rheumatism of the heart. Heart damage during the first rheumatic attack is observed in 90-95% of all patients. In this case, all three walls of the heart can be affected - the endocardium, myocardium and pericardium. In 20-25% of cases, rheumatic carditis ends up formed. main feature heart damage due to rheumatism in children and adults - extreme paucity of manifestations. Patients complain of discomfort in the heart area, shortness of breath and cough after physical activity, pain and interruptions in the heart area. As a rule, children remain silent about these complaints, not giving them serious importance. Therefore, heart damage can most often be detected during physical and instrumental examination.
- Rheumatism of the joints(rheumatic polyarthritis). Most often, pathological changes affect the elbow, knee and ankle joints. In a person with rheumatic arthritis, body temperature increases to 39 degrees, weakness increases, episodes of nosebleeds may occur, and sweating increases;
- Pulmonary form. It appears in combination with damage to the joints and heart, but is extremely rare (about 1-3% total number clinical cases). Develops in the form or;
- Skin form. It manifests itself as skin rashes or rheumatic nodules. Occurs in no more than 5% of cases;
- Rheumatism of the eyes. It is an integral part of the general manifestations of rheumatism in other organs. Characterized by damage to the retina (retinitis) or other parts of the eye (iritis, iridocyclitis, etc.). Complications may include partial or complete loss of vision.
Bacteriological and serological studies have shown that rheumatism is a special allergic reaction for infection with one of the beta hemolytic streptococci of group A.
First signs
Detection of rheumatism on early stages, especially if there is a predisposition to this disease, is very important for the effectiveness of its further treatment. However, as a rule, the diagnosis is made in the presence of reliable symptoms indicating the development of rheumatism. It is necessary to pay timely attention to both individual signs and their totality.
Signs to look out for:
- 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 a sore throat or pharyngitis.
- One of the most early signs rheumatism is joint pain, detected in 60-100% of patients ().
- Signs of heart damage are detected in 70-85% of cases. Complaints of a cardiac nature (pain in the heart area, palpitations, shortness of breath) are observed with severe cardiac disorders.
- More often, especially at the onset of the disease, various asthenic manifestations are observed (lethargy, malaise, increased fatigue).
Causes
A rheumatic attack is usually preceded by a streptococcal infection caused by group A β-hemolytic streptococcus:
- puerperal fever,
- erysipelas.
In 97% of patients who have had a streptococcal infection, a persistent immune response is formed. Other individuals do not develop stable immunity, and with repeated infection with β-hemolytic streptococcus, a complex autoimmune inflammatory reaction develops.
Factors contributing to the appearance and development of rheumatism are:
- reduced immunity;
- crowded groups (boarding schools, schools, dormitories);
- young age;
- unsatisfactory social and living conditions (food, housing);
- prolonged hypothermia;
- unfavorable family history.
Symptoms of rheumatism in an adult
Rheumatism is a polysymptomatic disease, which, along with general changes in the condition, is characterized by signs of damage to the heart, joints, nervous and respiratory system, as well as other organic structures. Most often, the disease makes itself felt 1-3 weeks after an infectious disease caused by group A β-hemolytic streptococcus.
A patient with rheumatism experiences the following symptoms:
- increase in body temperature to high numbers;
- tachycardia;
- headache;
- increased sweating;
- weakness;
- swelling and tenderness in the joints.
They are extremely similar to the common cold, but are caused by streptococcal colds and not viral infection. A characteristic difference is pain and swelling of large joints: elbow, ankle, knee, shoulder or wrist.
Typical symptoms of rheumatism are:
- heat, 38-40 degrees, fluctuations of which during the day are 1-2 C, increased sweating, chills, as a rule, no;
- against this background, muscle weakness and increased fatigue appear: pain in the joints;
- swelling of soft tissues.
Most often, the disease manifests itself in a few weeks due to previous infectious diseases, for example, after and pharyngitis.
As rheumatism progresses, other specific symptoms may appear - not always, on average they are recorded in 10% of cases:
- increased fragility of blood vessels - manifested in regular nosebleeds that occur suddenly;
- Annular rashes appear - they look like a rounded rash, with uneven edges, small rash Pink colour;
- rheumatic nodes are formed - they are localized in the anatomical locations of the affected joints, have the appearance of subcutaneous dense formations and are absolutely painless;
- the abdominal organs are affected - characterized by pain in the right hypochondrium, indicating the need for immediate hospitalization of the patient.
- The heart muscle (myocardium) and the inner lining of the heart chambers (endocardium) are affected - as a result, shortness of breath, rapid heartbeat, pain in the chest, and heart failure develops.
- Rheumatic inflammation of the heart wall (rheumatic carditis) often recurs, and heart defects gradually form.
- With rheumatism of the joints, sudden pain appears in one or several joints at once. The joints become red, swollen and hot. Most often the knees, ankles, elbow joints, wrists. Sometimes the hips are affected, shoulder joints and small joints of the feet and hands.
- Simultaneously with the appearance of joint pain, body temperature begins to rise. With rheumatism of the joints, the body temperature either decreases or rises again. Symptoms of rheumatism usually disappear within two weeks.
Complications
The development of complications of rheumatism is determined by the severity, protracted and continuously relapsing nature of the course. In the active phase of rheumatism, circulatory failure and atrial fibrillation may develop.
If you do not pay proper attention to the symptoms of rheumatism and do not consult a doctor in time, this disease can cause the following complications:
- become chronic, treatment of which can take up to several years;
- develop heart defects;
- cause heart failure;
- as a result of malfunctions of the heart, cause disturbances in the functioning of the circulatory system, which in turn can cause varicose veins, diseases of the kidneys, liver, respiratory organs, vision organs, etc.
- with exacerbation of all of the above symptoms and diseases, lead to death.
Diagnostics
Instrumental research methods include:
- ECG (cardiogram rarely reveals heart rhythm disturbances);
- Ultrasound of the heart;
- X-ray examination (allows us to determine an increase in the size of the heart, a change in its configuration, as well as a decrease in the contractile function of the myocardium);
Laboratory diagnosis of rheumatism:
- In the general blood test, an increase in ESR, a shift in the leukocyte formula to the left, are noted.
- In immunological analysis, ASG titers increase, the number of immunoglobulins of classes A, G, M increases, C-reactive protein, anticardiac antibodies and circulating immune complexes.
Treatment of rheumatism
How to treat rheumatism? Treatment of the disease in question must be carried out under the supervision of a specialist and most often the patient is placed in medical institution. There are a number of medications that are necessarily prescribed to patients as part of therapy for rheumatism. These include:
- Antibacterial drugs (penicillin followed by switching to bicillin5). In case of intolerance to penicillin, erythromycin can be used.
- Corticosteroids to provide a pronounced anti-inflammatory effect: Prednisolone. Since the use of corticosteroids affects water-salt metabolism, the patient is additionally prescribed potassium supplements (Asparkam, Panangin).
- non-steroidal anti-inflammatory drugs: Indomethacin, Ibuprofen, Xefocam, Revmoxicam, Dicloberl, etc.;
- hyposensitizing drugs;
- immunosuppressants: Azathioprine, Chlorobutin, Chloroquine, Hydroxychloroquine;
- glucocorticosteroids: Triamcinolone, Prednisolone.
- Aspirin. For rheumatism, this drug helps to quickly relieve the patient from pain in the joints and relieve swelling of the joints.
Treatment with hormones is now rarely used, and such drugs are prescribed only in some clinical cases.
Treatment of rheumatism is carried out according to a special scheme. It consists of three stages:
- Stage 1. Therapy is carried out in a hospital setting and lasts from 4 to 6 weeks. The first stage is the treatment of the disease at its peak of activity.
- Stage 2. This stage is a recovery stage after intensive therapy. Involves treatment in special sanatoriums or resorts.
- Stage 3. This stage is preventive. It involves annual preventive therapy, registration with a rheumatologist and constant monitoring by a doctor.
An acute attack of rheumatism is treated in a hospital. The patient is prescribed bed rest. Drug therapy depends on the clinical manifestations and form of the pathology and includes:
- glucocorticoids,
- anti-inflammatory drugs,
- antibiotics,
- drugs that stimulate the body's immune response,
- sedative dosage forms.
In the presence of heart damage, cardiac glycosides and diuretics are used.
The prognosis of rheumatism depends on the severity of damage to the tissues of the heart and joints (i.e., the presence and extent of myocardiosclerosis, the nature of damage to the heart valves). If the elimination of a rheumatic attack was started on time, then the disease is quite treatable, and the patient’s life is not in danger. The most unfavorable course is often recurrent rheumatism.
Folk remedies
It is necessary to use folk remedies for rheumatism only after the consent of the attending physician.
- Aconite decoction. Place 10 g of aconite root in a saucepan and pour 500 g of water into it. Cook the product for 2 hours over low heat. Next, cool the product, strain, and rub it on the affected areas 3 times a day.
- Lemon. Tincture of citrus fruits stimulates blood circulation and relieves inflammation. Cut 2 large lemons together with the peel, pour 0.4 liters of vodka or diluted alcohol into a glass container, seal it, and leave in a shaded place for three days. The liquid is used externally for rubbing, followed by insulation with woolen fabrics.
- Pour 10 g of St. John's wort herb 1 glass hot water, simmer for 30 minutes over low heat, cool and strain. For rheumatism, take 0.3 cups 3 times a day 30 minutes before meals. Store for no more than 3 days.
- Drink 2-3 glasses of corn silk decoction every day. Take a heated teaspoon of raw material into a glass of water and cook over low heat for 10 minutes. Drink for 6–8 weeks. The oldest muscular rheumatism disappears.
- Calamus (root) for bath. Pour 2 tablespoons of finely chopped calamus rhizomes into 1 liter of boiling water, boil for 20 minutes, leave for 30 minutes and strain. Take a bath (35-36°C) during the day or at night for rheumatism and gout. Course of treatment: 10-12 baths.
Prevention
Measures to prevent rheumatism include:
- timely detection of streptococcal infection, sanitation of the infectious focus;
- improvement of hygienic, social and living conditions of work and life;
- hardening;
- preventive use of antimicrobial and anti-inflammatory drugs in the autumn and spring periods.
Secondary prevention of rheumatism includes the following action plan:
- If the disease is active, then you should always be under the control of a rheumatic cardiologist. First, visit the doctor every month for 3 months from the onset of the disease, and then once a quarter. A prerequisite is to seek advice from a neurologist, ENT specialist, ophthalmologist, dentist, or gynecologist.
- Plasma donation for research should be carried out 6 times a year, and a urine test should be taken up to 4 times a year.
- Prevention of rheumatism is based on mandatory diagnostic measures. They should be carried out quarterly.
- Blood tests for rheumatic tests are carried out 4 times a year. If there is attenuation of the process and its transition to an inactive phase, then you should visit a rheumatic cardiologist 2–4 times a year.
This is all about rheumatism of the joints in adults: what kind of disease it is, what are its main symptoms and signs, features of treatment. Be healthy!
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Rheumatism is a systemic disease that affects the connective tissue in the human body. Most often, the disease occurs in children, and it is provoked by a streptococcal infection. But an adult can also develop rheumatism, especially in old age.
Rheumatism is serious illness, which provokes severe complications in the absence of timely treatment. The first signs of rheumatism in adults are a reason to immediately consult a doctor and begin treatment.
Manifestations of rheumatism in an adult
Many patients are sure that rheumatism is exclusively a joint disease, but in fact this is not the case. Since connective tissue is located throughout the body and in the internal organs, rheumatism can affect the heart, lungs, joints and even the skin.
In addition, joint inflammation is not the worst complication of rheumatism. Heart damage is much more dangerous, because even after a course of treatment there is a risk that a heart muscle defect will occur.
Symptoms of rheumatism in adults are very varied, so it is very important to go to the hospital and have tests done before starting treatment. The doctor will be able to assess the patient’s condition and provide a differential diagnosis.
Rheumatism in adults can manifest the following symptoms:
- Deterioration in general health, weakness, headache;
- Increased body temperature.
- The appearance of signs of arthritis: joints become red, painful, swollen;
- The appearance of signs of rheumatic carditis: heart pain, shortness of breath, swelling lower limbs;
- In case of defeat nervous system memory impairment, nervousness, depression are observed;
- When the skin is damaged, rashes appear in the form of ring-shaped erythema;
- When the kidneys are damaged, symptoms of inflammation are observed: pain, swelling of the lower extremities, constant thirst, decreased amount of urine.
- There may be a decrease in visual acuity.
- When blood vessels are damaged, signs of thrombosis are observed.
- Rheumatic lung disease is accompanied by signs of inflammation.
The disease begins abruptly 2-3 weeks after a staphylococcal infection, for example, sore throat, pharyngitis, or skin inflammation. The patient's temperature rises, joints become inflamed, and heart problems appear. Symptoms of damage to other internal organs usually appear less frequently, more often in advanced cases.
Temperature with rheumatism in an adult
Rheumatic fever in adults and children during an exacerbation is always accompanied by high body temperature. Sometimes the temperature reaches 40 degrees, but more often it stays around 38-39 degrees.
An increase in body temperature is accompanied by a deterioration in the general condition: the patient is worried about sweating, weakness, and nausea. The high temperature lasts no more than a week, and then subsides along with joint pain.
Sluggish rheumatism may be accompanied by a low temperature, no more than 37.5. Often patients do not even pay attention to it and continue to do normal activities until signs of arthritis or rheumatic heart disease appear. When treating rheumatism in adults, it is very important to pay attention to lowering body temperature.
Types of rheumatism in adults
Depending on the symptoms of rheumatism in adults, the diseases are divided into several types:
- Rheumatic polyarthritis. With this form, joints are affected, most often large ones, for example, knees and elbows. Small joints become inflamed quite rarely.
- Rheumatic carditis. With this type of rheumatism, heart damage occurs.
- Ring erythema is a skin manifestation of rheumatism. The disease manifests itself as large red spots on the body.
- Rheumatic chorea is a rare disorder that primarily affects children.
- Rheumatic pleurisy is a lesion of the lungs.
Most often, adults experience symptoms of rheumatic arthritis and rheumatic carditis, so you need to pay special attention to them. If a couple of weeks after a sore throat your heart or joints hurt, you should immediately consult a therapist.
The general practitioner will prescribe tests and refer you to a specialist - a rheumatologist. The sooner treatment begins, the greater the likelihood of avoiding heart disease and arthrosis in the future.
Rheumatism– inflammatory disease of connective tissues, mainly in the cardiovascular and musculoskeletal systems.
Other names for the disease: Sokolsky-Buyo disease, Acute rheumatic fever.
Rheumatism ICD
ICD-10: M79.0
ICD-9: 729.0
Most often, children and adolescents aged from 3 to 15 years are susceptible to rheumatism.
The development of rheumatism is provoked by a nasopharyngeal infection, which, when it enters the body, activates immune antibodies, which in turn begin to attack streptococcal molecules. The entry of streptococcus into the body causes diseases such as, etc.
The problem is that somewhat similar molecules are also found in connective tissue the heart and blood vessels of a person predisposed to rheumatism, and immune antibodies begin to attack them as well. Thus, the body begins inflammatory process called rheumatism.
To avoid rheumatism, it is necessary first of all to strengthen the immune system, and also to prevent various infectious diseases passed from acute to chronic form.
Let's look at the signs of rheumatism.
Symptoms of rheumatism are expressed in:
Rheumatism of the skin. Characterized by rheumatic nodules, ring or erythema nodosum, small hemorrhages, sweating,.
Rheumochorea (Dance of St. Vitus, rheumatism of the nervous system)– an inflammatory process inside the walls of small blood vessels in the brain. Characterized by the manifestation of small cerebral vessels, motor restlessness, arrogant activity, incoordination in movement, muscle weakness, disorders of the musculoskeletal system, mental disorders (aggression, lethargy, absent-mindedness, etc.).
Rheumopleurisy (rheumatism of the respiratory system). Characterized by chest pain, shortness of breath, fever, cough, pleural friction noise.
Rheumatism of the eyes. It is an integral part of the general manifestations of rheumatism in other organs. Characterized by damage to the retina (retinitis) or other parts of the eye (iritis, iridocyclitis, etc.). Complications may include partial or complete loss of vision.
Rheumatism of the digestive organs. Characterized by damage to the liver, kidneys and other gastrointestinal organs.
As already mentioned at the beginning of the article, the main cause of rheumatism is bacteria -. They can provoke the development of rheumatism:
Treatment of rheumatism is carried out comprehensively and is based on the relief of streptococcal infection, strengthening the immune system, as well as the prevention of pathological processes cardiovascular systems s.
Treatment of rheumatism is carried out in three stages:
1. Treatment of the disease in a hospital
Inpatient treatment of rheumatism is aimed at relieving streptococcal infections, as well as restoring the functionality of the cardiovascular system. It includes:
- in the acute course of the disease, bed rest is prescribed;
- for the treatment of rheumatism, one drug from nonsteroidal anti-inflammatory drugs (NSAIDs) and hormones are prescribed in combination or separately, depending on the etiology of the disease;
- to completely relieve the disease, NSAIDs are used for 1 month or more;
- for 10-14 days, antimicrobial therapy is carried out with penicillin drugs (“Bicillin”);
- if the symptoms of rheumatism often worsen or the disease is accompanied by other diseases caused by a streptococcal infection, for example, chronic tonsillitis, the period of treatment with penicillin is increased, or another antibiotic is additionally prescribed: "", "Amoxicillin", "Clarithromycin", "Roxithromycin" , “Cefuroxime axetil”, etc.
- Prednisolone is prescribed, in an individual dose, based on laboratory tests, which is taken at the initial dose for the first 10 days, after which its intake is reduced every 5-7 days by 2.5 mg, and so on until the drug is completely discontinued;
- quinoline drugs are prescribed, which, depending on the course of the disease, are taken from 5 months to several years;
- in case of serious pathological processes in the throat area, the doctor may prescribe tonsil removal.
2. Restoration of the immune and cardiovascular systems
Restoration of the immune and cardiovascular systems is prescribed mainly in health centers (sanatoriums), in which:
— continue to carry out antirheumatic therapy;
— if there are still any, various chronic diseases are treated;
- prescribe a diet that includes, first of all, food fortified;
- hardening of the body is prescribed;
- physical therapy is prescribed.
3. Periodic visits to the doctor
Periodic visits to the doctor are carried out at the local clinic, which is aimed at preventing the remission of rheumatism, as well as preventing this disease.
In addition, at the 3rd stage of treatment of rheumatism:
- continue to administer penicillin drugs in small doses (once every 2-4 weeks for 1 year);
— 2 times a year, instrumental and laboratory tests are carried out;
- prescribe special physical therapy;
- continue to strengthen the immune system with vitamins;
- Twice a year, in spring and autumn, along with the use of penicillin, a month-long course of taking non-steroidal anti-inflammatory drugs is carried out.
- if the course of the disease was not associated with heart damage, for 5 years after treatment of rheumatism, then take penicillin drugs.
Important! Before using folk remedies, be sure to consult your doctor.
Propolis. Form a cake from propolis, which you apply to sore spots while you sleep. It is advisable to wrap the product with a scarf so that it remains warm.
Propolis compress. You can also grate propolis and then pour wine alcohol into it. Leave the product in a dark place for 10 days, shaking it daily. On day 11, cool the resulting tincture in the refrigerator for 10 hours and strain. Use the resulting product as a compress to the sore spot. The compresses are wrapped with a woolen scarf on top to further warm the area. Only the product should be used carefully if there is damaged skin in the sore spot.
Propolis ointment. Propolis ointment has excellent analgesic, regenerative and anti-inflammatory properties. To prepare it, you need to heat about 100 g of Vaseline, then cool it to 50°C and add 10 g of crushed propolis to it. Place the resulting mixture on the stove and cook for another 10 minutes under the lid. Next, the product is cooled, filtered through gauze, and applied to the affected areas 2 times a day (morning and evening).
Pine needles. Fill a liter jar completely with May pine needles, then fill them with regular medical alcohol. Close the jar tightly with a lid and leave the product to infuse in a warm, dark place for 3 weeks, shaking it occasionally. After 3 weeks, strain the resulting product through cheesecloth and take 8 drops per piece of sugar before meals 3 times a day for 4-6 months.
Birch leaves. Stuff the clothes you sleep in with birch leaves. Cover yourself well so you can sweat. This way you need to sleep, but if you can’t sleep, then just sweat in the leaves for 3-4 hours and you can remove them. Also great folk remedy Birch baths are used for rheumatism. To do this, you need to fill the bath (30-50%) with birch leaves, let them steam, and then take a bath for 1 hour.
Aconite(be careful, aconite is a poisonous plant). To prepare aconite tincture, you need to pour 50 g of ground Djungarian aconite into 500 g of vodka, then close the jar tightly with a lid and leave to infuse for 2 weeks in a dark place, shaking the product periodically. Next, strain the product and store it in the refrigerator. At night, rub the sore spots with the tincture, then wrap them in flannel and tie them with a warm scarf. After removing the compress, wash the area with cold water.
Tincture of aconite. Pour 2.5-3 g of dry crushed aconite root into 100 g of vodka. Place the product in a dark place for 2 weeks, shaking it occasionally. Next, strain the product and take 1 drop with food for 1 day. Next 10 days, add 1 drop 3 times a day, also during meals. On day 11, take 10 drops during 3 meals. From 12 days, take one drop at a time. The course of treatment is carried out 3 times, with a break of 5 days.
Aconite decoction. Place 10 g of aconite root in a saucepan and pour 500 g of water into it. Cook the product for 2 hours over low heat. Next, cool the product, strain, and rub it on the affected areas 3 times a day.
Omega-3. Omega-3 has excellent anti-inflammatory, restorative and analgesic properties not only for rheumatism, but also for arthritis, arthrosis and other diseases of the musculoskeletal and cardiovascular systems. In addition, Omega-3 is an excellent anti-aging agent.