Arthritis. Inflammatory diseases of the joints, caused by various
reasons.
Gouty arthritis. One type of microcrystalline arthritis.
Gout - the disease deposits urate crystals in joints and other tissues
nyah, arising either due to increased decomposition of purine bases, there-
bo due to reduced excretion of uric acid by the kidneys.
Symptoms and flow. The disease is almost exclusively male, the average excitation
Rastas. Typically, recurrent arthritis, the joints of the lower extremities picks:
feet, ankles and knees. At least - the small joints of the hand, luchezapyast-
nye and elbow. Attack of arthritis often develops during the night, the intensity
pain is growing very rapidly, the movement in the joint becomes impossible,
the skin over it turns red, hot to the touch. Temperature may rise
body. Gouty attack provoked an excessive use of meat, al-
Cogolin, surgery, trauma, receiving diuretics, riboksina. In 15-20% of patients
Gout occurs urolithiasis, as well as interstitial petroleum
rit. In thicker skin over the joints (elbow, knee) or ear cartilage
shells are formed painful, various sizes nodular formation
of - deposits of uric acid crystals (tophi).
Recognition. Determination of elevated levels of uric acid in the blood-
integer.
Treatment. In order to suppress gouty attacks used non-steroidal
anti-inflammatory drugs (voltarep, brufen, indomethacin, ortofep
etc.). With recurrent arthritis, kidney damage, tophi - pozhiz-
nenny receiving allopurinol (milurita) to normalize the levels of uric
acid in the blood. The importance of a diet: the exclusion of alcohol,
decrease in food products containing a large number of purine oc-
Considerations - meat, fish and products thereof.
Artrityreaktivnye occur after infections (enterocolitis iersipioznyh-
Comrade, dysentery, gonorrhea, chlamydial infections of the urinary tract), have them-
munnokompleksnuyu nature.
Symptoms and flow. Mostly inflamed joints of the lower final
In particular, especially the toes, around which the skin becomes bluish
bagrovosinyushnuyu or color. Perhaps inflammation of the tendons in their places
attach to the bones. Can omechatsya and extraarticular symptoms: rash,
ulceration of the oral mucosa, inflammatory changes
vagina, penis, eyes (conjunctivitis), heart (myocarditis, peri-
carditis). In many cases, reactive arthritis short (from the bore-
How many days to several weeks), held their own, but the mo-
Jet and become chronic.
Recognition. The appearance of arthritis after an acute intestinal or
urinary infection, confirmation of the diagnosis - abjection, prov-
assertion of serological reactions.
Treatment is mainly nonsteroidal anti-inflammatory
drugs (indomethacin, orthofen, naproxen, etc.) and intra-
administration of corticosteroids. In protracted course - plasmapheresis.
Rheumatoid Arthritis - characterized mainly by chronic progressive
siruyuschim inflammation of many joints of the extremities, associated with the circulation in
the blood of immune complexes.
Symptoms and flow. The disease manifests persistent arthritis (commonly
polyarthritis) with early primary lesion and the small joints
hands and feet. Characterized by morning stiffness in painful swollen
joint pain, fever, skin over them. Symmetrical arthritis. In-
initial segment of the disease gradually, over an undulating, but steady progress,
croscopy: new joints are involved with the subsequent deformation of coarse-
her - "rheumatoid wrist," "rheumatoid foot." There may be vnesustav-
nye manifestations (pleuritis, pericarditis, myocarditis, liver enlargement, the village-
Sönke, lymph nodes).
Recognition is carried out on the basis of X-ray-ISS
study of erosion of the articular surfaces, determination of serum and
synovial fluid of rheumatoid factor. In the blood, increased erythrocyte sedimentation rate,
levels of fibrinogen, C-reactive protein.
Treatment. In the initial stage - non-steroidal anti-inflammatory
means (indometatsip, orthofen, voltaren, naproxen, ibuprofen, etc.).
In the most inflamed joints injected corticosteroid hormones (hydro-
cortisone metipred, kenolog). In severe cases, they carried a base-
rapiya: krizanol, D-penicillamine (kuprenil, metilkaptaze) delagil,
sulfasalazine. Suitable therapeutic exercise aimed at sup-
maximum content of joint mobility and the preservation of muscle mass, fi-
zioterapevticheskie procedure (electrophoresis, phonophoresis, magnet)
spa treatment. With persistent arthritis - a surgical technique:
synovectomy, reconstructive surgery.
Dermatomyositis (polymyositis). Systemic disease of skeletal and smooth
muscles and skin. Estimated cause of the disease - the virus (the virus
Coxsackie B2). Provoke disease-cooled, long-term exposure to
the sun, pregnancy, drug intolerance. In 20-30% of the derma-
tomiozit observed in patients with various tumors. The mechanism of development
diseases - disorders in the immune status. Women suffer in 2 times more likely
than men, with two peaks of age (puberty, a period of climate
max). Perhaps family and genetic predisposition.
Symptoms and flow. The disease begins more or less acute with the
lesions of the musculoskeletal system (muscle weakness, muscle pain), pain
joints, fever, skin lesions (various
rash, itching, redness, spotty, increased cornification, enhanced or
drastically reduced pigmentation, deposition of calcium in the skin or podkozh-
but the fat tissue), dense widespread edema. In the future, bo-
it is useful to acquire recurrent course. Lesion progresses skeleton
flight muscles - they are painful when moving and at rest, pain increases
with pressure on them, increases muscle weakness. The muscles of the shoulder and
pelvic girdle compressed, increasing in volume, violated their active
motions, the patients can not sit on their own, to raise his head from the
pillows. The defeat of the facial muscles leads to maskoobraznosgi person glotoch-
GOVERNMENTAL and breathing - to violations of swallowing and breathing, which also oc-
complicates frequent pneumonias. If the affected muscles of the eyes, then develops
double vision, strabismus, bilateral ptosis (drooping of the upper ve-
ka). Involvement of the heart muscle (myocarditis or miokardidistrofiya)
shown persistent increased heart rate, lower pressure, the emergence of
systolic murmur, can lead to heart-nedostatochnos
ty. One-third of patients - Raynaud's phenomenon (fingers turning blue whitening
cooling). Reduced or absent appetite, there are pains in the vivid-
those that may develop gastrointestinal bleeding, intestinal neproho-
being formed. There are three forms of the flow of dermatomyositis: acute with the rapid develop-
Thieme symptoms (may end in death within 36 months. due to heavy
lung and cardiovascular system), subacute, and chronic-
something. Changes in blood tests are nonspecific: mild leukocytosis with you-
Infected increase in the number of eosinophils (up to 25-70%), steady increase,
solution content of gamma-globulins in the blood and erythrocyte sedimentation rate.
Recognition is carried out on the basis of biochemical analysis of blood and
urine (creatine kinase enzyme levels), but the main role belongs to
Detection of specific changes in muscle biopsy.
Treatment. In the presence of a malignant tumor leads to its removal
stable improvement. Requires the use of high doses of glucocorticoid
hormones for a long time (prednisone, methylprednisolone).
You can also receive delagila, Plaquenil, indomethacin, brufen, butadiona;
important are the B vitamins, ascorbic acid. For ex-
zhennoy muscle weakness Neostigmine is used, anabolic steroids (non-
Rabolu, retabolil). After the inflammation subsided - physiotherapy,
massage.
Systemic lupus erythematosus. Chronic disease of the connective
tissue and blood vessels, caused by imperfections in the processes of genetically re-
triangulation immune system. Alleged cause of the disease
is a viral infection, acting on a background of altered immunity
as a result develop antibodies to their own organs and tissues
(Autoaggression). Proved family and genetic predisposition. Ill
mostly young women and adolescent girls. Provoking factors
tors are sun exposure, pregnancy, abortion,
beginning of the menstrual function, infection, drug allergy, postvak-
tsinalnye reaction.
Symptoms and flow. The disease begins gradually with a softly pronounced,
of inflammation of the joints, weakness and fatigue. Less commonly, there is an acute onset,
lo (high fever, acute inflammation of the joints, skin). In the future,
- Over undulating. A frequent sign - reddish rash on the skin
person as a "butterfly" in the upper half of the chest in the form of "de-
Colt "on the limbs. It is characterized by inflammation of the serous immune
membranes (pericardium, pleura, peritoneum). Pericarditis usually develops to
joined by myocarditis, endocarditis, sometimes, pleurisy, serous
peritonitis. Long before the typical pattern of disease may be symptoms
Reynaud. Lung leads to volchanochnomupnevmonitu: cough, dyspnea,
ka, moist rales in the lungs. There ulcerative stomatitis, the lack of up-
Petit, heartburn, burping, swollen lymph nodes, liver, and spleen. The most
severe manifestation - lupus diffuse glomerulonephritis (see). Is
and severe damage to the nervous system: encephalitis, polyneuritis, seizures,
hallucinations and delirium.
Recognition. Determination of high titers of antibodies to DNA, deoxyribonucleic
nucleotide antigen. To clarify the renal disease - needle biop-
is this the kidneys.
Treatment. Large doses of glucocorticoid hormones, with their inefficient
Nosta - immunosuppressants (azathioprine, cyclophosphamide) under the supervision of analytic
of blood. With an aggressive course of disease is used plasmapheresis. As per-
depending on the symptoms of the disease being symptomatic therapy
(Potassium preparations, tranquilizers, diuretics, antihypertensives, anabolic-
cal steroids, etc.). In the clinic - supporting vitamin
noterapiya. Climatotherapy, water treatment and ultraviolet irradiation pro-
tivopokazany (may cause a worsening of the disease).
Osteoarthritis. Disease in which degenerative changes in ha-
arise in the characters of the articular cartilage. In contrast, inflammation in arthritis
the joint is unstable and malovyrazhepnym. There are primary and sec-
Hex osteoarthritis (with dysplasia of the joints and bones, injuries of the joint,
ochronosis, hypothyroidism).
Symptoms and course depend on the localization of the disease. The most frequently
affects the joints of the first toe, knee, hip, and
interphalangeal joints of hands, others - less. Patients complain of pain
motion, and swelling in the joints, its thickening and deformation
tion, limited mobility in it. Changes in blood and urine
uncommon for osteoarthritis.
Treatment. The first correction of orthopedic defects, decreased
of body weight. Nonsteroidal anti-inflammatory drugs (indomethacin,
orthofen, naproxen) are taking for pain, intraarticular administration of gluco-
corticoids only with synovitis. Physiotherapy, physiotherapist
cal procedure. With persistent dysfunction of the joint - surgical
treatment.
Rheumatic disease (SokolskogoBuyo). Systemic inflammatory diseases,
tion of connective tissue, mainly affecting the heart and suck-
kyanite system. Develops due to acute infection (betagemolitiches-
cue group A streptococcus), mainly in children and adolescents (7-15
years). Streptococcal infection, especially massive, has a direct or
indirect damaging effect on the fabric more anti-
genes and toxins. Rheumatic fever predisposes to reduced immunity to the
streptococci, also notes the family-genetic predisposition.
Symptoms and flow. In typical cases, the disease develops after
1-3 weeks after undergoing a sore throat, at least another infection. Relapses
rheumatic disease often occur poslelyubyh infectious diseases, the opera-
tive interventions, physical overload. The most characteristic combination-
tion of acute migratory polyarthritis and fully reversible large sus-
tavov with moderate lesion of the heart (carditis). Top of diseases
usually of an acute, rapid. Rapidly developing arthritis, accom-
schiysya fever up to 38 40shS and strong then, but without the-Lake
Noba. Symmetrically affects large joints, knee, wrist,
ankle, elbow. They are swollen, the skin over them hot, stir in
They sharply painful. Typical "volatility" of inflammatory changes, pro-
which is in rapid (within days) regression of the art
riticheskih phenomena in some joints, and an equally rapid rise in their
other. Over time, all articular manifestations disappear. When in
expression of the heart muscle (myocarditis, rheumatoid) patients complain of a weak
bye pain or vague discomfort in the heart, small
shortness of breath on exertion, occasional palpitations, irregular. Dimensions
enlarged heart, changing his tone sonority, appear "soft"
noise. With the defeat of the endocardium (inner lining of the heart) are formed
revmatiticheskie heart defects (see Acquired defects). In addition,
lesions occur pericardium (see Pericarditis), skin: a ring-erite
ma - pink ring-shaped rash, never itchy, located
on the inner surface of the arms, legs, abdomen, neck and torso. Children in
expression of the central nervous system of small shows chorea (muscle
weak, violent movement ornate trunk, extremities, and Mimi-
Ceska muscles). In acute rheumatism in the blood increases the overall co-
lichestvo leukocytes, including neutrophils, the number of
platelet count, erythrocyte sedimentation rate. Contents protivostreptokokkovyh antibodies (antistrep-
togialuronidazy and antistreptokinazy, antistreptolysin) increases.
Recognition is carried out on the basis of clinical data: carditis, in
liartrit, chorea, erythema of the ring. Rheumatic nodules in conjunction with
fever of at least 38shS and laboratory indicators.
Treatment. Bed rest in the acute period. Used glyukokortiko-
idnye hormones (prednisolone, triamsinolon), voltaren and indomethacin,
quinoline drugs (delagil, Plaquenil). Outside the period of exacerbation-excitation
can be a spa treatment. To prevent recurrence revma-
ism carried bitsillinom preventive treatment is necessary, hut
gat cooling, acute respiratory diseases, treatment
heart failure.
Systemic scleroderma. Chronic disease of connective-
respect to tissue and small vessels with advanced lesions of the skin (glued-
Rose, fibrosis), connective-tissue framework of the internal organs. Cause
is unknown. Triggered by cooling, trauma, infection, vaccination and
etc. It is important semeypo-gepeticheskoe predisposition. Women suffer
3 times more often than men.
Symptoms and flow. The infection usually starts with Raynaud's syndrome (see
Section 2, ch. 1), joint pain, weight loss, fever, those
la, weakness, fatigue. The most characteristic sign - skin lesions.
First, there is a dense widespread edema in the future - Seal
and skin atrophy, particularly marked on the face and extremities. Perhaps in
phenomenon of ulceration and pustules on the fingers of the coccyx, long-unhealed
colliding, very painful. Deformed nails, hair falls down
to baldness. Painful seal, and then muscle atrophy is accompanied
Xia gross changes in tendons: they are shortened, which leads to time-
Development Board of contractures breaking activities of the various joints. They excitation-
pain arise, they are deformed. If you have X-ray-
is to destroy - end osteolysis, and in severe cases, secondary
phalanges of the hands, sometimes feet. In thicker subcutaneous tissue may be delayed
clumps of calcium. The disease affects the cardiovascular system.
There are pains in the heart, shortness of breath, a variety of cardiac
rhythm and conduction. When the immune vascular inflammation may occur
gangrene, thrombophlebitis with trophic ulcers on the feet, legs, etc.
There are severe lesions of internal organs: lungs - ppevmofibroz,
Kidney - "sklerodermicheskaya kidney", diffuse glomerulopefrit (see). Oso-
particularly characteristic of a violation of the passage of food through the esophagus, its expansion,
detectable by X-ray. The defeat of the nervous system
we have seen polyneuritis, autonomic instability (violation
sweating, thermoregulation), emotional (irritability, Plaka-
sivost and suspiciousness), insomnia. In rare cases, encephalitis occurs,
Literature and psychosis. There are acute, subacute, and chronic diseases
of. Changes in the blood of non-specific. The level of hemoglobin, mo-
Jet to increase the number of leukocytes, erythrocyte sedimentation rate.
Recognition. The diagnosis is confirmed by the detection of specific
changes in immunological status, and biopsy of the skin.
Treatment. Used high doses of glucocorticoid hormones (prednizo-
lon), and D-penicillamine, kuprenil, delagil. For the treatment of the syndrome
Raynaud's - nifedipine (corinfar, kordafen, foridon). Need symptomatic
hairdo therapy: lidasa, B vitamins, vasodilators, fiziotera-
troscopy (coniferous, radon, hydrogen sulfide baths, mud baths, parafinole-
chenie, etc.), therapeutic exercise, massage.
Periarteritis nodosa. Systemic inflammatory lesion of the arteries
medium and small caliber. The basis of the disease - an autoimmune lesion.
Suffer mainly men aged 30-40 years.
Symptoms and flow. The disease begins acutely or gradually
General symptoms (fever, fast-growing
schee weight loss), pain in joints, muscles, stomach, skin rashes,
signs of lesions of the gastrointestinal tract kishechpogo, heart, kidney, peripheral
Ceska nervous system. Almost all patients have glomerulonephritis,
rhythms, which usually leads rapidly to renal failure. In 70%
patients the attacks of angina pectoris, myocardial infarction may develop-
but without overt clinical signs. Sometimes Raynaud's syndrome, sometimes with
gangrene of the fingers. The defeat of the nervous system, manifested by multiple
neuritis, meningoencephalitis with speech impairments, hearing loss, headache,
dizziness, cramps, dimming of consciousness. One of the earliest symp-
volumes - the deterioration of vision due to central retinal vein thrombosis. At
lung disease occurs syndrome of asthma or pneumonitis. In
blood may increase the number of leukocytes, a large number of oo-
zinofilov, decreased hemoglobin, platelet count, erythrocyte sedimentation rate increases.
Recognition is carried out on the basis of histological study,
gation calf muscle biopsy or anterior abdominal wall.
Treatment. Large doses of glucocorticoid hormones, cytotoxic
drugs (cyclophosphamide, azathioprine). Prihronicheskom course of the disease -
therapeutic exercise, massage, hydrotherapy, reception delagila, Plaquenil.
reasons.
Gouty arthritis. One type of microcrystalline arthritis.
Gout - the disease deposits urate crystals in joints and other tissues
nyah, arising either due to increased decomposition of purine bases, there-
bo due to reduced excretion of uric acid by the kidneys.
Symptoms and flow. The disease is almost exclusively male, the average excitation
Rastas. Typically, recurrent arthritis, the joints of the lower extremities picks:
feet, ankles and knees. At least - the small joints of the hand, luchezapyast-
nye and elbow. Attack of arthritis often develops during the night, the intensity
pain is growing very rapidly, the movement in the joint becomes impossible,
the skin over it turns red, hot to the touch. Temperature may rise
body. Gouty attack provoked an excessive use of meat, al-
Cogolin, surgery, trauma, receiving diuretics, riboksina. In 15-20% of patients
Gout occurs urolithiasis, as well as interstitial petroleum
rit. In thicker skin over the joints (elbow, knee) or ear cartilage
shells are formed painful, various sizes nodular formation
of - deposits of uric acid crystals (tophi).
Recognition. Determination of elevated levels of uric acid in the blood-
integer.
Treatment. In order to suppress gouty attacks used non-steroidal
anti-inflammatory drugs (voltarep, brufen, indomethacin, ortofep
etc.). With recurrent arthritis, kidney damage, tophi - pozhiz-
nenny receiving allopurinol (milurita) to normalize the levels of uric
acid in the blood. The importance of a diet: the exclusion of alcohol,
decrease in food products containing a large number of purine oc-
Considerations - meat, fish and products thereof.
Artrityreaktivnye occur after infections (enterocolitis iersipioznyh-
Comrade, dysentery, gonorrhea, chlamydial infections of the urinary tract), have them-
munnokompleksnuyu nature.
Symptoms and flow. Mostly inflamed joints of the lower final
In particular, especially the toes, around which the skin becomes bluish
bagrovosinyushnuyu or color. Perhaps inflammation of the tendons in their places
attach to the bones. Can omechatsya and extraarticular symptoms: rash,
ulceration of the oral mucosa, inflammatory changes
vagina, penis, eyes (conjunctivitis), heart (myocarditis, peri-
carditis). In many cases, reactive arthritis short (from the bore-
How many days to several weeks), held their own, but the mo-
Jet and become chronic.
Recognition. The appearance of arthritis after an acute intestinal or
urinary infection, confirmation of the diagnosis - abjection, prov-
assertion of serological reactions.
Treatment is mainly nonsteroidal anti-inflammatory
drugs (indomethacin, orthofen, naproxen, etc.) and intra-
administration of corticosteroids. In protracted course - plasmapheresis.
Rheumatoid Arthritis - characterized mainly by chronic progressive
siruyuschim inflammation of many joints of the extremities, associated with the circulation in
the blood of immune complexes.
Symptoms and flow. The disease manifests persistent arthritis (commonly
polyarthritis) with early primary lesion and the small joints
hands and feet. Characterized by morning stiffness in painful swollen
joint pain, fever, skin over them. Symmetrical arthritis. In-
initial segment of the disease gradually, over an undulating, but steady progress,
croscopy: new joints are involved with the subsequent deformation of coarse-
her - "rheumatoid wrist," "rheumatoid foot." There may be vnesustav-
nye manifestations (pleuritis, pericarditis, myocarditis, liver enlargement, the village-
Sönke, lymph nodes).
Recognition is carried out on the basis of X-ray-ISS
study of erosion of the articular surfaces, determination of serum and
synovial fluid of rheumatoid factor. In the blood, increased erythrocyte sedimentation rate,
levels of fibrinogen, C-reactive protein.
Treatment. In the initial stage - non-steroidal anti-inflammatory
means (indometatsip, orthofen, voltaren, naproxen, ibuprofen, etc.).
In the most inflamed joints injected corticosteroid hormones (hydro-
cortisone metipred, kenolog). In severe cases, they carried a base-
rapiya: krizanol, D-penicillamine (kuprenil, metilkaptaze) delagil,
sulfasalazine. Suitable therapeutic exercise aimed at sup-
maximum content of joint mobility and the preservation of muscle mass, fi-
zioterapevticheskie procedure (electrophoresis, phonophoresis, magnet)
spa treatment. With persistent arthritis - a surgical technique:
synovectomy, reconstructive surgery.
Dermatomyositis (polymyositis). Systemic disease of skeletal and smooth
muscles and skin. Estimated cause of the disease - the virus (the virus
Coxsackie B2). Provoke disease-cooled, long-term exposure to
the sun, pregnancy, drug intolerance. In 20-30% of the derma-
tomiozit observed in patients with various tumors. The mechanism of development
diseases - disorders in the immune status. Women suffer in 2 times more likely
than men, with two peaks of age (puberty, a period of climate
max). Perhaps family and genetic predisposition.
Symptoms and flow. The disease begins more or less acute with the
lesions of the musculoskeletal system (muscle weakness, muscle pain), pain
joints, fever, skin lesions (various
rash, itching, redness, spotty, increased cornification, enhanced or
drastically reduced pigmentation, deposition of calcium in the skin or podkozh-
but the fat tissue), dense widespread edema. In the future, bo-
it is useful to acquire recurrent course. Lesion progresses skeleton
flight muscles - they are painful when moving and at rest, pain increases
with pressure on them, increases muscle weakness. The muscles of the shoulder and
pelvic girdle compressed, increasing in volume, violated their active
motions, the patients can not sit on their own, to raise his head from the
pillows. The defeat of the facial muscles leads to maskoobraznosgi person glotoch-
GOVERNMENTAL and breathing - to violations of swallowing and breathing, which also oc-
complicates frequent pneumonias. If the affected muscles of the eyes, then develops
double vision, strabismus, bilateral ptosis (drooping of the upper ve-
ka). Involvement of the heart muscle (myocarditis or miokardidistrofiya)
shown persistent increased heart rate, lower pressure, the emergence of
systolic murmur, can lead to heart-nedostatochnos
ty. One-third of patients - Raynaud's phenomenon (fingers turning blue whitening
cooling). Reduced or absent appetite, there are pains in the vivid-
those that may develop gastrointestinal bleeding, intestinal neproho-
being formed. There are three forms of the flow of dermatomyositis: acute with the rapid develop-
Thieme symptoms (may end in death within 36 months. due to heavy
lung and cardiovascular system), subacute, and chronic-
something. Changes in blood tests are nonspecific: mild leukocytosis with you-
Infected increase in the number of eosinophils (up to 25-70%), steady increase,
solution content of gamma-globulins in the blood and erythrocyte sedimentation rate.
Recognition is carried out on the basis of biochemical analysis of blood and
urine (creatine kinase enzyme levels), but the main role belongs to
Detection of specific changes in muscle biopsy.
Treatment. In the presence of a malignant tumor leads to its removal
stable improvement. Requires the use of high doses of glucocorticoid
hormones for a long time (prednisone, methylprednisolone).
You can also receive delagila, Plaquenil, indomethacin, brufen, butadiona;
important are the B vitamins, ascorbic acid. For ex-
zhennoy muscle weakness Neostigmine is used, anabolic steroids (non-
Rabolu, retabolil). After the inflammation subsided - physiotherapy,
massage.
Systemic lupus erythematosus. Chronic disease of the connective
tissue and blood vessels, caused by imperfections in the processes of genetically re-
triangulation immune system. Alleged cause of the disease
is a viral infection, acting on a background of altered immunity
as a result develop antibodies to their own organs and tissues
(Autoaggression). Proved family and genetic predisposition. Ill
mostly young women and adolescent girls. Provoking factors
tors are sun exposure, pregnancy, abortion,
beginning of the menstrual function, infection, drug allergy, postvak-
tsinalnye reaction.
Symptoms and flow. The disease begins gradually with a softly pronounced,
of inflammation of the joints, weakness and fatigue. Less commonly, there is an acute onset,
lo (high fever, acute inflammation of the joints, skin). In the future,
- Over undulating. A frequent sign - reddish rash on the skin
person as a "butterfly" in the upper half of the chest in the form of "de-
Colt "on the limbs. It is characterized by inflammation of the serous immune
membranes (pericardium, pleura, peritoneum). Pericarditis usually develops to
joined by myocarditis, endocarditis, sometimes, pleurisy, serous
peritonitis. Long before the typical pattern of disease may be symptoms
Reynaud. Lung leads to volchanochnomupnevmonitu: cough, dyspnea,
ka, moist rales in the lungs. There ulcerative stomatitis, the lack of up-
Petit, heartburn, burping, swollen lymph nodes, liver, and spleen. The most
severe manifestation - lupus diffuse glomerulonephritis (see). Is
and severe damage to the nervous system: encephalitis, polyneuritis, seizures,
hallucinations and delirium.
Recognition. Determination of high titers of antibodies to DNA, deoxyribonucleic
nucleotide antigen. To clarify the renal disease - needle biop-
is this the kidneys.
Treatment. Large doses of glucocorticoid hormones, with their inefficient
Nosta - immunosuppressants (azathioprine, cyclophosphamide) under the supervision of analytic
of blood. With an aggressive course of disease is used plasmapheresis. As per-
depending on the symptoms of the disease being symptomatic therapy
(Potassium preparations, tranquilizers, diuretics, antihypertensives, anabolic-
cal steroids, etc.). In the clinic - supporting vitamin
noterapiya. Climatotherapy, water treatment and ultraviolet irradiation pro-
tivopokazany (may cause a worsening of the disease).
Osteoarthritis. Disease in which degenerative changes in ha-
arise in the characters of the articular cartilage. In contrast, inflammation in arthritis
the joint is unstable and malovyrazhepnym. There are primary and sec-
Hex osteoarthritis (with dysplasia of the joints and bones, injuries of the joint,
ochronosis, hypothyroidism).
Symptoms and course depend on the localization of the disease. The most frequently
affects the joints of the first toe, knee, hip, and
interphalangeal joints of hands, others - less. Patients complain of pain
motion, and swelling in the joints, its thickening and deformation
tion, limited mobility in it. Changes in blood and urine
uncommon for osteoarthritis.
Treatment. The first correction of orthopedic defects, decreased
of body weight. Nonsteroidal anti-inflammatory drugs (indomethacin,
orthofen, naproxen) are taking for pain, intraarticular administration of gluco-
corticoids only with synovitis. Physiotherapy, physiotherapist
cal procedure. With persistent dysfunction of the joint - surgical
treatment.
Rheumatic disease (SokolskogoBuyo). Systemic inflammatory diseases,
tion of connective tissue, mainly affecting the heart and suck-
kyanite system. Develops due to acute infection (betagemolitiches-
cue group A streptococcus), mainly in children and adolescents (7-15
years). Streptococcal infection, especially massive, has a direct or
indirect damaging effect on the fabric more anti-
genes and toxins. Rheumatic fever predisposes to reduced immunity to the
streptococci, also notes the family-genetic predisposition.
Symptoms and flow. In typical cases, the disease develops after
1-3 weeks after undergoing a sore throat, at least another infection. Relapses
rheumatic disease often occur poslelyubyh infectious diseases, the opera-
tive interventions, physical overload. The most characteristic combination-
tion of acute migratory polyarthritis and fully reversible large sus-
tavov with moderate lesion of the heart (carditis). Top of diseases
usually of an acute, rapid. Rapidly developing arthritis, accom-
schiysya fever up to 38 40shS and strong then, but without the-Lake
Noba. Symmetrically affects large joints, knee, wrist,
ankle, elbow. They are swollen, the skin over them hot, stir in
They sharply painful. Typical "volatility" of inflammatory changes, pro-
which is in rapid (within days) regression of the art
riticheskih phenomena in some joints, and an equally rapid rise in their
other. Over time, all articular manifestations disappear. When in
expression of the heart muscle (myocarditis, rheumatoid) patients complain of a weak
bye pain or vague discomfort in the heart, small
shortness of breath on exertion, occasional palpitations, irregular. Dimensions
enlarged heart, changing his tone sonority, appear "soft"
noise. With the defeat of the endocardium (inner lining of the heart) are formed
revmatiticheskie heart defects (see Acquired defects). In addition,
lesions occur pericardium (see Pericarditis), skin: a ring-erite
ma - pink ring-shaped rash, never itchy, located
on the inner surface of the arms, legs, abdomen, neck and torso. Children in
expression of the central nervous system of small shows chorea (muscle
weak, violent movement ornate trunk, extremities, and Mimi-
Ceska muscles). In acute rheumatism in the blood increases the overall co-
lichestvo leukocytes, including neutrophils, the number of
platelet count, erythrocyte sedimentation rate. Contents protivostreptokokkovyh antibodies (antistrep-
togialuronidazy and antistreptokinazy, antistreptolysin) increases.
Recognition is carried out on the basis of clinical data: carditis, in
liartrit, chorea, erythema of the ring. Rheumatic nodules in conjunction with
fever of at least 38shS and laboratory indicators.
Treatment. Bed rest in the acute period. Used glyukokortiko-
idnye hormones (prednisolone, triamsinolon), voltaren and indomethacin,
quinoline drugs (delagil, Plaquenil). Outside the period of exacerbation-excitation
can be a spa treatment. To prevent recurrence revma-
ism carried bitsillinom preventive treatment is necessary, hut
gat cooling, acute respiratory diseases, treatment
heart failure.
Systemic scleroderma. Chronic disease of connective-
respect to tissue and small vessels with advanced lesions of the skin (glued-
Rose, fibrosis), connective-tissue framework of the internal organs. Cause
is unknown. Triggered by cooling, trauma, infection, vaccination and
etc. It is important semeypo-gepeticheskoe predisposition. Women suffer
3 times more often than men.
Symptoms and flow. The infection usually starts with Raynaud's syndrome (see
Section 2, ch. 1), joint pain, weight loss, fever, those
la, weakness, fatigue. The most characteristic sign - skin lesions.
First, there is a dense widespread edema in the future - Seal
and skin atrophy, particularly marked on the face and extremities. Perhaps in
phenomenon of ulceration and pustules on the fingers of the coccyx, long-unhealed
colliding, very painful. Deformed nails, hair falls down
to baldness. Painful seal, and then muscle atrophy is accompanied
Xia gross changes in tendons: they are shortened, which leads to time-
Development Board of contractures breaking activities of the various joints. They excitation-
pain arise, they are deformed. If you have X-ray-
is to destroy - end osteolysis, and in severe cases, secondary
phalanges of the hands, sometimes feet. In thicker subcutaneous tissue may be delayed
clumps of calcium. The disease affects the cardiovascular system.
There are pains in the heart, shortness of breath, a variety of cardiac
rhythm and conduction. When the immune vascular inflammation may occur
gangrene, thrombophlebitis with trophic ulcers on the feet, legs, etc.
There are severe lesions of internal organs: lungs - ppevmofibroz,
Kidney - "sklerodermicheskaya kidney", diffuse glomerulopefrit (see). Oso-
particularly characteristic of a violation of the passage of food through the esophagus, its expansion,
detectable by X-ray. The defeat of the nervous system
we have seen polyneuritis, autonomic instability (violation
sweating, thermoregulation), emotional (irritability, Plaka-
sivost and suspiciousness), insomnia. In rare cases, encephalitis occurs,
Literature and psychosis. There are acute, subacute, and chronic diseases
of. Changes in the blood of non-specific. The level of hemoglobin, mo-
Jet to increase the number of leukocytes, erythrocyte sedimentation rate.
Recognition. The diagnosis is confirmed by the detection of specific
changes in immunological status, and biopsy of the skin.
Treatment. Used high doses of glucocorticoid hormones (prednizo-
lon), and D-penicillamine, kuprenil, delagil. For the treatment of the syndrome
Raynaud's - nifedipine (corinfar, kordafen, foridon). Need symptomatic
hairdo therapy: lidasa, B vitamins, vasodilators, fiziotera-
troscopy (coniferous, radon, hydrogen sulfide baths, mud baths, parafinole-
chenie, etc.), therapeutic exercise, massage.
Periarteritis nodosa. Systemic inflammatory lesion of the arteries
medium and small caliber. The basis of the disease - an autoimmune lesion.
Suffer mainly men aged 30-40 years.
Symptoms and flow. The disease begins acutely or gradually
General symptoms (fever, fast-growing
schee weight loss), pain in joints, muscles, stomach, skin rashes,
signs of lesions of the gastrointestinal tract kishechpogo, heart, kidney, peripheral
Ceska nervous system. Almost all patients have glomerulonephritis,
rhythms, which usually leads rapidly to renal failure. In 70%
patients the attacks of angina pectoris, myocardial infarction may develop-
but without overt clinical signs. Sometimes Raynaud's syndrome, sometimes with
gangrene of the fingers. The defeat of the nervous system, manifested by multiple
neuritis, meningoencephalitis with speech impairments, hearing loss, headache,
dizziness, cramps, dimming of consciousness. One of the earliest symp-
volumes - the deterioration of vision due to central retinal vein thrombosis. At
lung disease occurs syndrome of asthma or pneumonitis. In
blood may increase the number of leukocytes, a large number of oo-
zinofilov, decreased hemoglobin, platelet count, erythrocyte sedimentation rate increases.
Recognition is carried out on the basis of histological study,
gation calf muscle biopsy or anterior abdominal wall.
Treatment. Large doses of glucocorticoid hormones, cytotoxic
drugs (cyclophosphamide, azathioprine). Prihronicheskom course of the disease -
therapeutic exercise, massage, hydrotherapy, reception delagila, Plaquenil.
No comments:
Post a Comment