Clinical classification of rheumatism

Pages: 1 2 3 4 5 6 7

II degree of activity related moderately expressed clinical signs of rheumatic fever, accompanied low or normal temperature, moderate or weak manifestations of exudative component of inflammation in the affected organs. Clinically detected symptoms of acute carditis, sometimes in combination with subacute polyarthritis, or, more often, polyarthralgia, Korea, skin manifestations of rheumatism, etc. acute-phase indicators of inflammation respectively clinical symptoms expressed moderately.
Finally, I degree indicative minimum, are often difficult to identify signs of active disease. They are found in the decay phase of acute or sub-acute rheumatism, a significant number of patients with a prolonged course of the process. Minimal activity may show some decrease of working ability, growth or stability of the symptoms of circulatory disorders in the presence of valvular heart disease, cardiac complaints, emerging only when probing questions of the doctor. X-ray and ECG symptoms very poor, very unusual, its dynamics over the long observation expressed weakly. Laboratory parameters used for determining the activity of the rheumatic process, normal or only minor variations. In this regard, the definition of I degree of activity unlike the maximum and moderate often difficult and is feasible only if a detailed comprehensive dynamic monitoring of the patient. It is in these cases is of particular importance are constantly introduced into clinical practice more sensitive immunological, terminologicheskii, tool-the graphical methods. However, they are often not sufficiently informative. It is clear, as morphological substrate minimal activity are granulomatous or focal interstitial processes microcinema exudative component of inflammation.
In classification (see table. 2) presents clinical-anatomical characteristics of rheumatism. First of all dedicated heart failure, and then other possible localized rheumatic process. Used the term "rheumatic heart disease" implies the desirability of further decryption with clarification involved in the inflammatory process of one or another lining of the heart (endocarditis, myocarditis, pericarditis) and their combinations. With the purpose of attracting attention to early diagnostics of inflammatory lesions of the heart made a division of rheumatic heart disease in primary and recurrent. In the same column are rheumatism without apparent change of heart, and myocardiosclerosis and rheumatic heart disease as the outcome of the previous active rheumatic processes. It should be borne in mind the peculiarity of sclerotic processes for rheumatism. In particular, all morphologists noted that in areas of sclerosis and hyalinosis can observe a fresh outbreak of fibrinoid, the tumor vessels, arteriovenous anastomoses. Clinicians are well known great danger of relapse in patients with heart defects, therefore, careful observation and in the inactive phase should be a compulsory measure of secondary prevention of relapse.
In the column "the nature of the course" presents five main options of the flow of rheumatism. For the characteristic features of flow used clinical-time principle, according to which the active phase of rheumatoid arthritis may be acute, subacute and three options chronic (prolonged, continuous recurrent and latent).