Palindromny rheumatism

Description:

Palindromny rheumatism - extremely rare form of inflammatory damage of joints and periartikulyarny fabrics which is characterized by repeated short and completely return attacks. Equally often have this disease of the man and woman.

Nosological isolation of this disease at many researchers raises doubts. Really, approximately at 50% of patients with this diagnosis the pseudorheumatism develops afterwards. The disease gets strong indications of gout, an ankylosing spondylarthritis or other rheumatic diseases, including hard currency from one patients eventually, others periodically have short-term reversible attacks of arthritis for many years.

Reasons of palindromny rheumatism:

Before the present time are not studied. The role of an infection and allergy in development of palindromny rheumatism is not confirmed.

Symptoms of palindromny rheumatism:

The clinical picture is characterized by signs of inflammatory damage of joints and periartikulyarny fabrics. Arthritis begins suddenly, usually in the second half of day, reaching a maximum of clinical manifestations within several hours. Pains, a swelling, reddening, increase in local temperature and restriction of volume of movements in one are noted, is more rare in two joints. Preferential shoulder, radiocarpal, interphalangeal, metacarpophalangeal, ankle, knee, temporal and maxillary joints and cervical department of a backbone are surprised. Joint pains have the pulsing character, their intensity can be various — from insignificant to the drugs which are sharply expressed, forcing to use. The attack can remind a picture of acute gouty arthritis.

At a third of patients puffiness of periartikulyarny fabrics and regional muscles is observed. Besides, small hypodermic dense educations (small knots) which are localized on extensive side of small joints of brushes and feet over palmar aponeuroses are found. Small knots usually remain within several hours or days (3-7 days).

Joint and periartikulyarny changes are not followed by fervescence, oznoba and other manifestations.

It should be noted a lymphocytosis (to 50%). In the acute period increase in SOE up to 35 mm/h is possible. Radiological changes of joints are not defined.

Course of a disease long, recurrent. A recurrence arises with irregular intervals, is sometimes quite frequent — several times a month. Process spontaneously is exposed to involution within several days (no more than 7-8 days), without causing permanent changes of joints and usually without influencing a functional condition of patients. At a recurrence there is no tendency to damage of the same joints, every time process has other localization.

Diagnosis:

The diagnosis is based on a peculiar "instant" beginning of a disease, short duration of the attacks, lack of signs of systemacity of defeat.

Palindromny rheumatism should be distinguished from an intermittent hydrarthrosis which recurrence arises through identical periods, and process is localized practically always in the same joint and is not arthritis by the nature.

Treatment of palindromny rheumatism:

During the attacks in connection with a pain syndrome non-steroidal anti-inflammatory drugs are shown, and at especially sharp pains — corticosteroids inside or vnutrisustavno.