Arthritis chronic nonspecific

Arthritis chronic nonspecificARTHRITIS CHRONIC NONSPECIFIC (infektartrit) - see rheumatoid Arthritis in Chapter "Rheumatic diseases". The clinical features in children. The disease begins at the age of 2-4 years, sometimes in the first year of life. Marked fever, intoxication, swelling and tenderness of the joints, initially, large (knee, elbow, ankle, hip); then suffer the cervical part of the spine, wrist, jaw, joints of fingers. Defeat symmetric. Change the shape of the joints. In them, sometimes there is a small amount of exudate. Children complain of pain in the joints during movement, especially during extension. When you attack these complaints are more pronounced. After the defeat of the joint can be noted atrophy and hypotonia of the muscles. At the same time experiencing multiple muscle contracture. In severe cases, changes and bone. X-ray signs of enhanced bone tissue from the periosteum and at the same time its resorption. Swelling in the joints periosteum, granulation tissue lead to the ability of cartilage, the foci of destruction that is the cause deformation of joints and surfaces of the bones. In the place of the granulation is formed of fibrous scar tissue, which leads to subluxations and dislocations. Following the defeat of joints develops regional lymph nodes, which reaches its maximum value within a few days. In a reverse development process in the joints they decrease. Nodes slightly painful, plotnosty, not fused with the skin, not nagnaivajutsja. The temperature curve in typical cases wavy. The liver is increased by 2-3 cm, sometimes increased spleen. In the study of cardiac function determined by the tendency to tachycardia, myocardial. Blood - anemia, increased ESR, first leukocytosis, then radiation. The diagnosis is based on the anamnesis and the clinical picture. The differential diagnosis spend with rheumatic fever, tuberculous arthritis; arthritis brucellosis, trauma, leukemia, lupus. The treatment is carried out in the hospital with compliance in acute period of strict bed rest, with the provision of the necessary care for the child. In the acute stage individually according to the indications of the possible use of antibiotics. Use of nonsteroidal anti-inflammatory drugs (acetylsalicylic acid, phenylbutazone, amidopyrine), antihistamines. Glucocorticoids are used in short courses of 1-2 weeks, more likely to use prednisolone. Children of school age with severe disease course in complex therapy or if necessary, cancel glucocorticoids used as indomethacin, brufen, immunodepression, delagil, chloroquine. In the complex therapy using non-specific stimulants, vitamins, physical therapy, aloe, transfusion of blood plasma. Since the beginning of the recovery apply therapeutic massage and gymnastics. In remission spend sanatorium-resort treatment; possible surgical correction (consultation of the surgeon-orthopedist). The prognosis for active complex treatment is favorable, but if the progression of the disease is serious. Prevention. The organization of proper supervision and care of children to prevent disease, the spread of streptococcal infection. Compliance with the rules of preventive vaccination. Of some importance is the prevention of relapses and Pro-dressirovannye disease..



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