The Ching

The Ching (Zvereva scurvy) is a specific infectious disease of the joints of the fingers (monoethnic) with a tendency to chronic course.
The etiology of the disease is not clear. People suffer, leading the hunt seals and other marine animals involved in cutting their carcasses and processing of raw materials.
5-7 days after minor skin damage (scratches, abrasions) pain and limited mobility in one of the joints of the fingers, swelling, which increases in 2-3 weeks. Further decreases swelling, pain subsides. The process ends with the development of frets (see) and contractures (see). Transferred disease leaves no immunity.
Treatment Ching: infiltration tissue at the base of the finger 0.25% solution novokaina. Appoint terramycin, tetracycline 600 000 to 800 000 IU per day; up to 5 000 000 - 10 000 000 IU per course. At strong edema - paraartikulyarnye sections of tense fabrics.
Prevention Ching: hand protection from damage gloves, after working hands processing 0.25% solution of ammonia, wash with warm water.

The Ching is a specific infectious monoethnic fingers with a tendency to chronic course. The degree of defeat of joints may be different until the development of bone ankylosis and deforming artresources. The disease is spread among the population of the coast of the Northern seas (Barents and White). The population of the polar region refers to Ching-Tsinghai, like many diseases associated with the development of a lump. Message diplococci as the causative agent Ching made in 1949 and 1950, A. Orlov, M., Grishanina and 3. A. The Great.
The source of infection - white sea lysun, or harp seal (Phoca groenlandica)and bearded seals. Infectious agent penetrates through the damaged areas of the hand and fingers. The incubation period is from 2 to 30 days. Early symptom is pain at the site of damage. At first she was dumb and spreads throughout the brush, then is localized at one of the joints. Because of restrictions on the movements of the brush patients become incapacitated. Often affects the joints of his left hand, as in the right hunters at work keep cutting tools. The pain gradually increased and is whining or throbbing in nature. Broken General condition, developed insomnia. Changes of internal organs is not observed. The temperature does not rise.
Simultaneously with the pain appears the second sign Ching - swelling of the tissues of the patient's finger. The finger skin becomes white colour due to the stress of tissues. Finger hard, feel lost. Active movements are absent. After 3-4 weeks you receive crunch (crepitus). There destruction of the articular surfaces. When you cut tissue is separated a small amount of bloody mass or serous fluid. Pus, as a rule, does not happen. After 2 weeks, the process is suspended, reverse development is very slow (6-8 weeks).
Clinically, there are three forms: paraartikulyarnye, articulate and mixed. The first usually ends recovery. When articular form a tendency to relapsing and chronic course with the formation of false or true ankylosis. Deformation finger last for a lifetime. A mixed form attached purulent inflammation of the fingers and hands. Y. Scherbak.
X-ray diagnostics. When articular form, there are significant destructive changes in the elements that make up the joint, resembling in the initial phases of development Ching x-ray picture of pyogenic arthritis (see).
However, only in 10-13 days after onset of the disease on an x-ray can detect narrowing of the joint space in one of joints affected finger, due to the destruction of the articular cartilage. The first x-ray signs of Ching in the bone tissue appear not earlier than in 17-28 days after onset of the disease. During this period on the radiograph in the epiphyseal end phalanges defined focus rarefaction of bone structure. Through 30-37 days after the onset of chingay articular gap in the affected joint disappears completely. Podgradina strip cortical bone substance places is interrupted and not traced throughout; sometimes it disappears completely. Articular end after its destruction is often rough, rutted path that indicates the spread destruction and bone epiphyses phalanges. Lots of rarefaction of bone structures become more extensive. In rare cases, completely destroyed the epiphysis of the limbs or their metaphysi (Fig). As a rule, the process involved both metaepiphysis joint. The defeat of divisov phalanges not a characteristic of the disease chingay.
If a timely started treatment destructive changes are less or not detected. Periosteal layers in acute periods of the disease are rare, but the awl-shaped bone growth, showing the reaction of the periosteum, in chronic period of a disease occur quite frequently. Often destructive changes in the cartilage and bone of the epiphyses lead to subluxations.
Through 47-48 days after onset of illness with appropriate treatment in the radiograph first symptoms of recovery process in the form of small plots sclerosis. In untreated cases reparative changes come much later - after 4.5 - 5 months.
Articular form Ching usually ends with the development of bone frets deforming artresources, rarely blundering joint. If the disease ends with the formation of frets, then after 8-12 months. on the radiograph can celebrate a partial transition of bone structure is one of the phalanx in the area of bone structure is different. True bony ankylosis develops within a few years. If the Ching ends with the formation of deforming artresources, the free edges of the joint surfaces have different values subulate and mushroom-shaped bone growth, subchondral bone strip sklerosiruta, the epiphyses of the phalanges thicken, flattened. After 2 to 3 years after the disease deformation joint slightly expressed, whereas in 9 -10 years found rough bone changes.
When a tottering joint noted the complete absence of the epiphyses of the phalanges, the width of the joint space for up to 6 mm Articular ends formed naked beams of the spongy substance of metamizol phalanxes and have rough, rutted. Bone structure metamizol under the articular ends sclerotic (fibrous).
Treatment is aimed at the thorough processing of the hearth wounded, and later perform surgical treatment (dissection of tissues). Radiotherapy effective in the early period of the disease. Apply protivoglaucomnoe serum Century, Popov).
Prevention is the prevention of damage to the arms and the timely processing of the damage. Pay attention to the serviceability of the equipment St. John's wort. Conduct routine inspections.

The Ching distal interphalangeal joint of the third finger of the left hand (44-day sickness). Destructive changes in the epiphyses of the phalanges, forming joint: 1 - direct planar projection; 2 - side projection.