Acute articular rheumatism

Synonyms

Rheumatic fever, Acute rheumatic fever, Inflammatory rheumatism, Acute rheumatism

Overview

Acute articular rheumatism is most common in adults and involves symptoms such as fever and arthritis. Acute rheumatic fever (ARF) is a complication of a strep throat caused by particular strains of GAS. Although common in developing countries, ARF is rare in the United States, with small isolated outbreaks reported only occasionally. It is most common among children between 5-15 years of age. A family history of ARF may predispose an individual to the disease. Symptoms typically occur 18 days after an untreated strep throat. An acute attack lasts approximately 3 months.

Symptoms

  • Fever
  • Appetite loss
  • Malaise

Joint symptoms

  • Arthritis
  • Arthritis-like symptoms
  • Joint pain
  • Swollen joints
  • Warm joints
  • Wrist joint symptoms
  • Elbow symptoms
  • Ankle symptoms
  • Knee symptoms
  • Often multiple joints affected

Heart symptoms

  • Heart murmur
  • Heart inflammation (carditis)
  • Heart failure - see also symptoms of heart failure
  • Edema
  • Shortness of breath
  • Weakness

Skin symptoms

  • Skin changes
  • Skin rash (Erythema marginatum)

Abdominal pain

  • Nervous system symptoms
  • Chorea
  • Sydenham's chorea
  • Writhing spasms

Causes

Some of the causes of Acute articular rheumatism are included in the list below:

  • Streptococcus
  • Streptococcal infections
  • Group A streptococcus
  • Strep throat
  • Scarlet fever

Diagnosis

Abrupt joint inflammation, with its concomitants plainly marked, and fever, is easily distinguishable from other disorders. Arthritis from other causes must be distinguished by the history and often by the persistent fixed location of the inflammation. Septic arthritis, often taken for this disease, follows other acute disorders, especially the exanthemata. Gonorrhceal rheumatism has a previous history of gonorrhoea and has but little elevation of temperature. Osteomyelitis seldom attacks other than the hip joint, and whatever joint is attacked, the bone is involved, rather than the structures of the joint. Monoarticular rheumatism has a previous history of gout and syphilis.

Treatment

Fever and pain are the primary indications for treatment in acute rheumatic fever.

Resources

  • NIH