Diagnosis Of Rheumatic Fever (RF) by toriola1

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									                                     Presented by Daniel Toriola


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                                     Diagnosis Of Rheumatic Fever (RF)
                                                  By K Bakhru



   The diagnosis of RF at times becomes difficult, especially when the various clinical manifestations
occur either independently, or in varied combinations. In such a situation, other points need to be
considered, like presence of fever, pain in joints (arthralgia) i.e. when typical painful swollen joints were
not present in the patient earlierar any of the manifestations of RF /RHD. Some laboratory tests may
also aid in the diagnosis like ECG, and various blood tests like raised erythrocyte sedimentation rate
(ESR), presence of C-reactive protein and raised leucocyte count (leucocytosis).

The above-mentioned are only minor criteria for the diagnosis of the RF. The major criteria for
diagnosing RF remain the painful swelling of various joints (polyarthritis), involvement of heart (when
on examination the physician finds murmurs, pericardial rub or signs of pericardial effusion i.e. fluid in
the pericardial cavity surrounding the heart), including other major clinical features of the disease like
rheumatic chorea/nodules, erythema marginatum, described earlier.

If anyone of the above-mentioned major criteria is present in a patient, and it is associated with any two
of the minor criteria, the patient is in rheumatic activity, and needs urgent treatment. Alternatively, if the
patient has the two major criteria, with or without any minor criteria, an acute stage of the disease
should be considered.

The idea is that early diagnosis should not be missed in any case, and the patient, if an adult, or the
parents of the child, should be careful enough to keep the physician in touch with the various
symptoms of RF.

In addition to the above criteria, if in a patient some evidence of infection of the specific organism, i.e.
group A streptococcus is available, that further helps in diagnosis, and therefore, blood examination for
antibodies to streptococci, or a throat culture may be carried out, if possible. However, there are no
precise tests for the diagnosis of RF, and it is only through the overall clinical picture and a few general
tests that the diagnosis can be reached. Other tests, like echocardiography, radiographs may also be
required, depending upon the case.

Why is early diagnosis vital?

The most severe complication of the recurrence of various attacks of RF is that the heart may be



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                                 Presented by Daniel Toriola


damaged permanently, called chronic RHO, requiring surgical intervention to improve the functioning of
the heart. The other manifestations of RF like involvement of joints etc., disappear completely even if
the disease is recurrent. It may look astonishing to the readers that the joints which become adversely
affected as a result of the disease, making the child/adult incapacitated, on recovery, become perfectly
normal without any sign of impairment left in the joints. But this may not happen so far as the heart is
concerned. Each attack of RF may damage the heart, and this damage may be added during each
recurrence of the disease. One may say in a lighter vein that the disease only frightens the joints, but
severely beats/damages the heart.

The prevention of RHO lies in the early diagnosis and treatment of acute RF. In the heart, it is the
valves that are permanently damaged, as a result of recurrent allergic effects on the valves. Once the
patient has been properly diagnosed, further attacks of RF /RHO can be prevented by the prophylactic
use of antibiotics for sore throat, and hence saving the heart from permanent damage.

Author sites: http://www.herbalremedieslk.com , http://shabi-home-remedies.blogspot.com ,
http://www.e-self-help.com




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                                   Presented by Daniel Toriola


                            Arthritis, One Of The Many Rheumatic Diseases
                                            By Ethan Armitage



 The main common characteristics of the rheumatic conditions are represented by inflammations,
followed by a disability of one of the body's supporting structures. The most affected by rheumatic
diseases are the articulations, ligaments, bones, tendons and muscles that become painful, swollen
and rigid. Some of the 100 types of rheumatic disorders may affect the other organs.

Some people generically call "arthritis" any kind of rheumatic problem. But, unlike the other conditions,
arthritis only attacks the articulations. There are some rheumatic diseases that are considered
disorders of connective tissues, while others are seen as auto immune.

Some rheumatic diseases are :

* - Rheumatic arthritis is a disease in which the synovium is swollen and very painful. The articulations
hurt, become rigid and are severely damaged or taken out of use. The articulations of the hand of the
feet are the most affected. Rheumatic arthritis is a symmetrical disease, which affects 1% of the
population, only in the U.S.

* - Juvenile rheumatic arthritis is the most frequent arthritis that affects children. Most of the symptoms
are common to those of the adults, but there are others to be added such as rashes and fever

* - Osteoarthritis affects the cartilages and makes them wear away. It causes pain of the articulations,
rigidity, and in case it touches the spine, disables it ,the knees and hips, too. It is the most frequent
form of arthritis and it affects over 21 millions of Americans

* - Systematic lupus erythematosus has a auto immune character. The healthy cells and tissues are
damaged by the organism's own means of protecting itself against infections. The inflammation
produced by this disease attacks the skin, the articulations, the kidneys, the brain, the blood vessels,
the heart and the lungs.

* - Spondyloarthopathies that mostly attack the spine have, as any common form of ankylosing
spondylitis. The spine is followed by the shoulders, hips and knees, then the inflammation extends over
the tendons and ligaments, which become painful and rigid. It mostly affects young people. Other
example of spondyloarthopathy is Reiter's syndrome, an infection of the bowel, the lower urinary tract
and causes skin rashes, eye problems and mouth sores.

* - Fibromylagia has a chronic character and gives the articulations and the tissues that determine the
bones to move, pain, rigidity, and localized sensitivity of the muscles and tendons. It especially affects
the spine, shoulders, hips and neck and causes the patient insomnia and tiredness.

* - Scleroderma, or systematic sclerosis affects the skin, articulations and blood vessels, and,
sometimes, internal organs. It is caused by an over increased quantity of collagen inside the body.

* - Polymylagia rheumatica is very painful and causes rigidity of the shoulders, hips, neck and lower
back, especially in the morning. It affects tendons, muscles, ligaments and everything that surrounds
the articulations. In time, it may degenerate into giant cell arthritis, a disorder that affects the arteries



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                                   Presented by Daniel Toriola


and generates weight loss, fever, swelling and weakness.

* - Gout is a type of arthritis generated by the deposits of uric acid crystals in the articulations. Has as
main symptoms inflammation, swelling, and almost unbearable pain

* - Psoriatic arthritis affects only people with psoriasis. It mostly affects the fingers and toes'
articulations and it modifies the aspect of the nails. In case it touches the spine, back pain is added to
the symptoms

* - Infectious arthritis is caused by viruses or bacteria. Two examples are gonococcal arthritis and
parvovirus arthritis. The symptoms of arthritis often appear in Lyme disease. This disease is generated
by bacterial infection that occurs after the bite of some ticks.

An early diagnosis is vital to prevent a serious damage.

* - Tendinitis is, as the name says, a disorder of the tendons. They become inflamed, painful and
extremely sensitive and produce restriction of movement

* - Bursitis is produced by the swelling of the bursae, it generates sensitivity and pain and limits the
movements of the close articulations

* - Polymyositis weakens and inflames the muscle. It may cause disability, in case it affects the entire
body.

For more information visit http://www.arthritissymptomsandtreatment.com




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                               Presented by Daniel Toriola




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