What is Palindromic Rheumatism?

The onset of each attack is sudden and often begins in the evening. It involves 1 or 2 joints. The pain in the affected joints is very obvious. It reaches a peak in a few hours. Red, swollen, hot, and painful joints and / or surrounding soft tissues are visible. The duration is very short, the pain usually disappears within 1 to 3 days, the longest is not more than 1 week. No symptoms during the interval. There is no clear regularity of seizures, most of them may occur several times a week, and lesser ones may occur once or twice a year. Any joint can be affected, including knees, wrists, shoulders, and ankles. Hand joints are the most common. Hip, elbow, foot, spine, and temporomandibular joints are rare. Recurrences are often localized to previously attacked joints, and joints can also be transformed. In addition to joints, joints can also be affected, such as edema and pain in finger pads, heels, and other soft tissues. Individual patients have low fever during the episode and generally have no systemic symptoms. Occasionally, subcutaneous nodules stumble, but disappear quickly and are not easy to find.

Rheumatism

Rhobic rheumatism is also known as paroxysmal rheumatism, Hench-Rosenberg syndrome, Hench syndrome, and recurrent rheumatism. The disease is more common in people between 30 and 60 years of age, and occasionally can develop in childhood. More than one person may develop the same family. Equal opportunities for men and women. "Relief" is a feature used to describe the rapid appearance and disappearance of symptoms. Each episode begins acutely with a single or a few joints and can reach a peak within a few hours. The joint pain is obvious and lasts for hours to days. Rarely more than a week, the joints between episodes are completely normal, similar to a gouty arthritis attack.

Symptoms of rheumatism

The onset of each attack is sudden and often begins in the evening. It involves 1 or 2 joints. The pain in the affected joints is very obvious. It reaches a peak in a few hours. Red, swollen, hot, and painful joints and / or surrounding soft tissues are visible. The duration is very short, the pain usually disappears within 1 to 3 days, the longest is not more than 1 week. No symptoms during the interval. There is no clear regularity of seizures, most of them can occur several times a week, and lesser ones occur once or twice a year. Any joint can be affected, including knees, wrists, shoulders, and ankles. Hand joints are the most common. Hip, elbow, foot, spine, and temporomandibular joints are rare. Recurrences are often localized to previously attacked joints, and joints can also be transformed. In addition to joints, joints can also be affected, such as edema and pain in finger pads, heels, and other soft tissues. Individual patients have low fever during the episode and generally have no systemic symptoms. Occasionally, subcutaneous nodules stumble, but disappear quickly and are not easy to find.

Rheumatism pathology

Little is known about the pathogenesis of this disease. Because some cases eventually developed rheumatoid arthritis, and obvious microvascular damage and a large number of cell debris and electron density deposits in the vessel wall were found during joint synovial biopsy, it was proposed that immune complexes may participate in the Onset. Immunoelectron microscopy was performed on the diseased nodules of PR patients, and immunoglobulins and complements were found in the vacuoles of vascular endothelial cells and tissues surrounding the blood vessels, thereby supporting the idea that the immune complex is pathogenic. Some think this disease is an independent disease, and some think it is a subtype of rheumatoid arthritis. Many rheumatoid factors are positive.

Clinical diagnosis of rheumatism

Mainly depends on clinical manifestations. Typical cases of acute arthritis and periarthritis are recurrent, without any symptoms between episodes, and without specific changes on X-ray examination, the diagnosis of rheumatism can be made. If there is only a mild attack without redness, the disease cannot be diagnosed.

Labyrinth Rheumatism Lab Test

Erythrocyte sedimentation and various acute response indicators can increase during an episode. Synovial and synovial fluid examination revealed non-specific acute inflammatory reactions but no crystals. Synovial biopsy showed obvious microvascular damage. Complement levels did not decrease in serum and synovial fluid. The above-mentioned indicators are within the normal range during the intermission period.

Other rheumatism examinations

X-ray examination during the attack showed no abnormalities except swelling of the affected joint tissue.

Rheumatism treatment

Western medicine treatment of rheumatism

Since the onset of this disease is short, it can resolve itself within 1 to 3 days, so it is difficult to judge the efficacy of its treatment. Anti-inflammatory drugs have no obvious effect on the disease, and long-term application cannot effectively prevent seizures. The most commonly used drugs are the following. (1) Gold preparation: It is the most effective medicine for treating this disease. About half of the patients respond to injection of gold preparation. The mechanism of action is unclear. There are two commonly used gold preparations: gold sodium thiomalate and gold glucosamine, both containing 50% gold, the former being an aqueous agent and the latter being an oil suspension. The administration scheme is similar to the treatment of rheumatoid arthritis, but the dose is relatively small, 20 mg per week, intramuscular injection, generally used to a total of 1.0 g discontinuation. In order to reduce side effects, after the symptoms are basically controlled, change to 10 mg per week or increase the interval between each administration. However, relapse can occur within a few years after discontinuation of the drug, and sometimes it can also occur during the maintenance phase of reduction. At this time, the dose should be increased again. Side effects: There is obvious pain in the intramuscular injection, and some patients may have stomatitis, dermatitis, gastrointestinal reactions, kidney damage and hematopoietic system damage.

(2) Adrenal corticosteroids: Low-dose prednisone can be used for patients with frequent attacks, severe severity, and contraindications to gold preparations.

(3) Penicillamine: can significantly reduce the number of attacks and prevent the disease from developing into rheumatoid arthritis. The dose is 20mg / d for 1 year. The side effects include fever, headache, gastrointestinal symptoms, leukopenia, and impaired renal function. Avoid kidney disease. It should be tested for penicillin allergy before use.

(4) Colchicine: This medicine has the effect of reducing leukocyte activity and phagocytosis, as well as anti-inflammatory and analgesic effects. Intermittent medication can prevent seizures and is reported to have some effect.

TCM treatment of rheumatism

It can be treated according to the theory of "wind paralysis", and treatment with Qufengliangxue, Shujinhuoluo and analgesic drugs is effective. According to reports, the "one search and one stop" therapy of Tongluo Kaibi Tablets has satisfactory results.

Prognosis of rheumatism

Symptoms resolve on their own in about 10% of cases; most patients can have recurrent attacks without persistent synovitis or joint damage; 30% to 40% of cases develop into typical rheumatoid arthritis. These patients are often positive for rheumatoid factor during the relapse period, and those who were originally negative can also become positive during the progression period. Typical rheumatoid nodules persist during the relapse period before chronic synovitis occurs. Once rheumatoid arthritis progresses to rheumatoid arthritis, the frequency of attacks is more frequent, but the severity is reduced, at the same time, the number of affected joints is increased, and morning stiffness is more obvious. The time from onset of rheumatoid arthritis to rheumatoid arthritis ranges from 5 to 20 years. The disease does not generally develop into systemic lupus erythematosus or other connective tissue disease.