Polyarthritis chronic nonspecific

Polyarthritis chronic nonspecific (infectious arthritis) - see Arthritis rvmatoidny in the chapter "Rheumatic diseases."

Features of the clinic in children. The disease begins at the age of 2-4 years, sometimes in the first year of life. There are feverish condition, intoxication, swelling and tenderness of the joints, at first large (knee, elbow, ankle, hip); Then suffer the cervical spine, wrist, jaw, and finger joints. The defeat is symmetrical. The shape of the joints changes. They sometimes show a small amount of exudate. Children complain of soreness in the joints during movement, especially when extending. With repeated attacks, these complaints are more pronounced. After the development of joint damage, we can note atrophy and hypotension of muscles. Simultaneously there are multiple muscle contractures. In advanced cases, the bone tissue also changes. On the roentgenogram - signs of increased bone formation from the periosteum and at the same time its resorption. The periosteum that grows in the region of the joint, granulation tissue leads to cartilage usurpers, foci of destruction, which causes the deformation of the joints and the surfaces of the bones. At the place of granulation, fibro-scar tissue forms, which leads to subluxation and dislocation.

Following the defeat of the joints, a regional increase in lymph nodes develops, which reach a maximum value within a few days. With the reverse development of the process in the joints, they decrease. The knots are slightly painful, dense, not soldered to the skin, do not swell. The temperature curve is typically wavy in typical cases. The liver is enlarged by 2-3 cm, sometimes the spleen is enlarged. In the study of heart function, the tendency to tachycardia, myocardial dystrophy, is determined. In the blood - anemia, increased ESR, first leukocytosis, then leukopenia.

The diagnosis is based on the history and clinical picture. Differential diagnosis is performed with rheumatic, tuberculous arthritis; Arthritis in cases of brucellosis, trauma, leukemia, lupus erythematosus. Treatment is carried out in a hospital with observance in the acute period of strict bed rest, with the necessary care for the child. In the acute stage, according to indications, antibiotic use is possible. Non-steroidal anti-inflammatory drugs (acetylsalicylic acid, butadione, amidopyrine), antihistamines are used. Glucocorticoids are used in short courses 1-2 weeks, more often they use prednisolone.

At children of school age at a serious disease course in a complex of therapy or if necessary to abolish glucocorticoids, indomethacin, brufen, immunosuppressants, deligil, chloroquine are also used. In a complex of therapy use nonspecific stimulating agents - vitamins, physiotherapy, aloe, transfusions of blood plasma. From the beginning of recovery, therapeutic massage and gymnastics are used.

In the period of remission, sanatorium-and-spa treatment is provided; Possible surgical correction (consultation of an orthopedic surgeon). The prognosis with active complex treatment is relatively favorable, but in the case of disease progression - serious.

Prevention. Organization of correct observation and care of children in order to prevent the incidence of, the spread of streptococcal infection. Compliance with the rules of carrying out preventive vaccinations. The prevention of recurrences and progressing of the disease is of definite importance.