OVERVIEW
Overview of Rheumatism
Recurrent rheumatism (Palindromic rheumatism) is also known as exacerbating rheumatism and recurrent rheumatism. It is an uncommon form of recurrent acute arthritis and periarthritis with no deformity or impairment of the joints and no serologic abnormalities. Clinical manifestations are stiffness, pain, and swelling of the joints, recurrent and self-limiting.
Whether medical insurance
yes
Department
Rheumatology and Immunology
Synonyms: Henoch-Rosenberg syndrome, episodic rheumatism, recurrent rheumatism
Henoch-Rosenberg syndrome, episodic rheumatism, recurrent rheumatism
Clinical Symptoms
Stiffness, pain and swelling in the joints, recurrent and self-limiting.
Hazards
The disease can lead to urticaria and angioedema, with more frequent attacks after progression to rheumatoid arthritis.
Examination
X-rays, rheumatoid factor, histopathologic examination, etc.
Diagnosis
Diagnosis is based on the manifestations of joint stiffness, pain, swelling, and recurrent episodes, combined with X-ray film, rheumatoid factor, and histopathologic examination.
Treatment principle
Anti-inflammatory and analgesic drugs are mostly used for symptomatic treatment.
Curability
Symptoms can be improved by active treatment.
Dietary advice
Give high-protein, high-calorie, easy-to-digest food, and eat less spicy and stimulating and cold, greasy food.
Causes
Etiology
The cause is unknown.
Symptoms and Diagnosis
Typical Symptoms
The disease can develop at any age. The onset of the disease is often sudden with no antecedent symptoms. Joint pain occurs in the late afternoon and is more common in the limbs, knees, shoulders, wrists, elbows, ankles, palms, and metatarsals, and may be single or multiple joints, usually asymmetrical. Local symptoms range from stiffness to pain, with the dorsal skin of most joints ranging from dark red to bright red, and swelling with paroxysmal pain. Arthritic symptoms usually resolve within 1 week. The rash and arthritis occur at the same time, often near the joints, but also away from the joints. It is characterized by exudative erythema with spontaneous pain and tenderness, about 4 cm in size, which is erythematous and disappears within a few hours to 24 h. In a few cases, it may be present on the elbows and knees. In a few cases, intradermal and subcutaneous nodules, the size of green beans, may appear on the elbows, knees, wrists, finger bellies, and the backs of the fingers, disappearing in a few days to a few weeks. There are no systemic symptoms such as fever, which may recur.
Diagnostic basis
1. Clinical manifestations are often sudden onset, limbs, knees, shoulders, wrists, elbows, ankles, palms, metatarsals and other joints are more common, can be single or multiple joints involved. Local symptoms range from stiffness to pain, swelling with paroxysmal pain. Arthritic symptoms usually disappear within 1 week. The rash and arthritis occur simultaneously, often near the joints, but also away from the joints. It is characterized by an exudative erythema with spontaneous pain and tenderness, about 4 cm in size, which is erythematous and disappears in a few hours to 24 hours. 2. 2. Auxiliary examination (1) X-ray: no bone changes are seen in the affected joints. (2) Rheumatoid factor examination: some cases are positive for rheumatoid factor, and most of the positive cases evolve into rheumatoid arthritis later. (3) Histopathological examination: polymorphonuclear leukocyte exudative reaction is seen in synovial membrane of arthritis. Erythema tissue image for dermal edema and perivascular lymphocytes, polymorphonuclear leukocytes infiltration of vasculitis performance. The nodular histologic picture is a nonspecific inflammation with fibroblast proliferation.
Treatment
Treatment
Symptomatic treatment with anti-inflammatory and analgesic drugs.
Drug therapy
Non-specific anti-inflammatory drugs, such as indomethacin, hydroxychloroquine or penicillamine can be given in the acute stage.
Other treatments
During the period of remission, attention should be paid to improving the body resistance and preventing recurrence.
Prognosis
In a few patients, the symptoms may subside on their own, and most patients may have recurrent episodes without persistent inflammation or joint damage. Some patients with positive rheumatoid factor tests may evolve into rheumatoid arthritis later.
Nursing care
Daily care
1. Acute joint swelling should be bed rest, limit the activities of the affected joints. 2. Keep the air in the room fresh and the bed flat. 3. Wash with lukewarm water, prohibit the use of cold water.
Dietary management
Give high-protein, high-calorie, easy-to-digest food, and eat less spicy and stimulating and cold and greasy food.